Organization Active NPI

Arlington Dermatology SC

  • Dermatology Physician
  • Rolling Meadows, IL
National Provider Identifier
1689692386
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ARLINGTON DERMATOLOGY SC
Practice address
5301 Keystone CT
Rolling Meadows, IL 60008
Phone
(847) 392-5440
NPI assigned
Jul 18, 2006
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Ursula Cholewa
Title
Practice Administrator
Phone
(847) 392-5440

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 042000859 IL
Dermatology Physician 207N00000X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

5301 Keystone CT
Rolling Meadows, IL 60008

Mailing address

5301 Keystone CT
Rolling Meadows, IL 60008-3811
Phone (847) 392-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050601000456 IL Part B Supplier - Clinic/Group Practice 8628010550 Receives reassigned benefits from 6 practitioners
Practice locations: Rolling Meadows, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0686979Arlington Dermatology5301 Keystone Court, Rolling Meadows, IL 60008AccreditationNov 10, 2026

National Provider Directory

National Provider Directory

Locations

1100 W Central Rd
Ste 200
Arlington Heights, IL 60005
Phone (847) 392-5440

5301 Keystone Ct
Rolling Meadows, IL 60008
Phone (847) 392-5440

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1689692386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 KEYSTONE CT",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083811",
            "telephone_number": "847-392-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 KEYSTONE CT",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "60008",
            "telephone_number": "847-392-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARLINGTON DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-04-20",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "CHOLEWA",
        "authorized_official_first_name": "URSULA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-392-5440"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "042000859",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Meadows, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.