PA Skin Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PA SKIN INC

Practice address

19624 Governors Hwy # 309
Flossmoor, IL 60422-2077

Phone

(773) 339-8152

NPI assigned

Feb 19, 2024

Last updated

Feb 19, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paje Schantz, LE

Title

President

Phone

(708) 738-9881

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1679338727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 RIDGE RD UNIT 460",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604304627",
            "telephone_number": "708-738-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY # 309",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222077",
            "telephone_number": "773-339-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PA SKIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-18",
        "status": "A",
        "authorized_official_last_name": "SCHANTZ",
        "authorized_official_first_name": "PAJE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-738-9881",
        "authorized_official_credential": "LE"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.