Jordan C. Carqueville, MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JORDAN C. CARQUEVILLE, MD LLC

Doing business as

Derm Institute of Chicago

Practice address

737 N Michigan Ave Ste 720
Chicago, IL 60611-6661

Phone

(312) 319-1978

Fax

(312) 262-7791

NPI assigned

Jul 31, 2019

Last updated

Jan 11, 2025By 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

Marc Wezowski, MS, JD

Title

Managing Director

Phone

(312) 319-1978

Specialties & licenses 4

Addresses

Other names 1

• Derm Institute of Chicago Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 26

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.

• Stephanie Bayers, MD

  • Dermatology Physician
  • Hinsdale, IL
  • NPI 1346668902
  Medicare reassignment Care Compare group NPD
• Jordan Claire Carqueville, MD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1285830166
  Medicare reassignment Care Compare group NPD
• Inyoung Kim, MD, PHD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1730567264
  Medicare reassignment Care Compare group NPD
• Kaitlyn M Kollmann, MD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1790219814
  Medicare reassignment Care Compare group NPD
• Chase W Kwon, MD

  • Dermatology Physician
  • Hinsdale, IL
  • NPI 1801384029
  Medicare reassignment Care Compare group NPD
• Madison Nicole Petersen, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1467288043
  Medicare reassignment Care Compare group NPD
• Samantha Phillips

  • Dermatology Physician
  • Chicago, IL
  • NPI 1275168460
  Medicare reassignment Care Compare group NPD
• Carla Sanchez-Palacios, M.D.

  • Dermatology Physician
  • Hinsdale, IL
  • NPI 1417914466
  Medicare reassignment Care Compare group NPD
• Pamela L Scheinman, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1669429601
  Medicare reassignment Care Compare group NPD
• Megan Reingold

  • Physician Assistant
  • Highland Park, IL
  • NPI 1285325936
  Medicare reassignment Care Compare group
• Jill Katherine Cotseones, DO

  • Dermatology Physician
  • Geneva, IL
  • NPI 1740523539
  Medicare reassignment NPD
• Rachel Bognet, M.D.

  • Dermatology Physician
  • Hinsdale, IL
  • NPI 1811158298
  NPD

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1710531330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 N YORK RD STE 100",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213515",
            "telephone_number": "312-319-1978",
            "fax_number": "312-262-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 N MICHIGAN AVE STE 720",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116661",
            "telephone_number": "312-319-1978",
            "fax_number": "312-262-7791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 W Wilson Ave Ste 6119",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606405259",
            "country_code": "US",
            "telephone_number": "312-319-1978",
            "fax_number": "312-262-7791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4905 Old Orchard Ctr Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600771458",
            "country_code": "US",
            "telephone_number": "312-319-1978",
            "fax_number": "312-262-7791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 N York Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605213515",
            "country_code": "US",
            "telephone_number": "312-319-1978",
            "fax_number": "312-262-7791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JORDAN C. CARQUEVILLE, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-31",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "WEZOWSKI",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "312-319-1978",
        "authorized_official_credential": "MS, JD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derm Institute of Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael S Joo, M.D.
• Min J Joo, MD
• Anna Joong, MD
• David A Jopp, PHD
• Joseph Joppich
• Jordan Ferranto Psychotherapy Services (Felt Studio)
• Jordan Ledger, DDS, PC (Chicago Oral Surgery & Implant Center)
• Jordan Sadler SLP LLC
• Jordan Speech-Language Therapy PLLC
• Alyssa Nicole Jordan, CNA

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.