Northwest Dermatology, S.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

NORTHWEST DERMATOLOGY, S.C.

Practice address

2500 W. Higgins Road
Suite 1040
Hoffman Estates, IL 60169

Phone

(847) 884-8096

Fax

(847) 884-8125

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jean M. Bacarella

Title

Office Manager

Phone

(847) 884-8096

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790706547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W. HIGGINS ROAD",
            "address_2": "SUITE 1040",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-884-8096",
            "fax_number": "847-884-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W. HIGGINS ROAD",
            "address_2": "SUITE 1040",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "60169",
            "telephone_number": "847-884-8096",
            "fax_number": "847-884-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BACARELLA",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-884-8096",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0001617988",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.