Charming Skin Med Spa SC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CHARMING SKIN MED SPA SC

Practice address

2425 W 22ND St Ste 216
Oak Brook, IL 60523-4662

Phone

(708) 974-4270

Fax

(888) 466-3320

NPI assigned

Feb 17, 2012

Organization subpart

No

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

Authorized official

Name

Jawdat Abboud, MDNPI 1417964370

Title

Owner

Phone

(708) 974-4270

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jawdat Abboud, MD

  • Primary Care Clinic/Center
  • Oak Brook, IL
  • NPI 1417964370
  Medicare reassignment NPD Authorized official
• Darshna Patel, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Des Plaines, IL
  • NPI 1558626457
  NPD (past)
• Mansoor Virani, DPM

  • Foot & Ankle Surgery Podiatrist
  • Villa Park, IL
  • NPI 1669487146

  Single Specialty

  NPD (past)
• Huma Haroon Vaid, D.P.M.

  • Podiatrist
  • Austin, TX
  • NPI 1881048817
  NPD (past)

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1710250089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST STE 216",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234662",
            "telephone_number": "708-974-4270",
            "fax_number": "888-466-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST STE 216",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234662",
            "telephone_number": "708-974-4270",
            "fax_number": "888-466-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARMING SKIN MED SPA SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "ABBOUD",
        "authorized_official_first_name": "JAWDAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-974-4270",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087208",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centerwell Certified Healthcare Corp.
• Centurion Hospice & Palliative Care, Inc
• Breanna Cerrentano
• Jennifer Chamblin
• Lakenya Chapman, RBT
• Minal Keyur Chauhan, DPT
• Marine Chaurize
• Jag M Chawla, D.D.S
• Angela Chen
• Jackson W Chen, M.D.

• Clinic/Center in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.