Reserve Dermatology & Aesthetics PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RESERVE DERMATOLOGY & AESTHETICS PLLC

Practice address

2350 Ravine Way Ste 400
Glenview, IL 60025-7621

Phone

(847) 400-2542

Fax

(847) 221-6935

NPI assigned

Sep 7, 2021

Organization subpart

No

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

Authorized official

Name

Elizabeth Damstetter, MDNPI 1184935611

Title

Owner

Phone

(847) 400-2542

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Elizabeth Marie Damstetter, M.D.

  • Dermatology Physician
  • Glenview, IL
  • NPI 1184935611
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1760151542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 RAVINE WAY STE 400",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257621",
            "telephone_number": "847-400-2542",
            "fax_number": "847-221-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 RAVINE WAY STE 400",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257621",
            "telephone_number": "847-400-2542",
            "fax_number": "847-221-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESERVE DERMATOLOGY & AESTHETICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "DAMSTETTER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-400-2542",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.