Individual provider Active NPI

Christina Tejeda

  • Dermatology Physician
  • Skokie, IL
National Provider Identifier
1851851315
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036.165148 Issued in IL
Practice address
4709 Golf Rd Ste 600
Skokie, IL 60076-1253
Phone
(708) 482-3213
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036.165148 IL Primary

Addresses

Primary practice location

4709 Golf Rd Ste 600
Skokie, IL 60076-1253

Mailing address

2755 Hawks Landing Blvd
Palm Harbor, FL 34685-1752
Phone (727) 365-9976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230810002503 IL Practitioner - Dermatology 3072849876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Columbia University College of Physicians and Surgeons, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Lagrange SCGroup PAC ID 7113830951, 19 clinicians

Practice addresses (Care Compare)

4709 Golf Rd
Suite 600
Skokie, IL 60076-1253
Phone (847) 677-2080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.78 of 100Reported as group
Quality
87.26
Promoting interoperability
100
Improvement activities
40
Cost
58.68

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of tissue1-10
Removal of skin lesions951
Removal or shaving of skin growth61
Skin biopsy189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.165148ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Lagrange SC Dermatology CurrentSince Sep 1, 2023 Accepting new patients

Locations

5201 Willow Springs Rd
Ste 130
La Grange Highlands, IL 60525
Phone (708) 354-5631

5201 Willow Springs Rd
Ste 430
La Grange Highlands, IL 60525
Phone (708) 482-3213

4709 Golf Rd
Ste 600
Skokie, IL 60076
Phone (708) 482-3213

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1851851315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 HAWKS LANDING BLVD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346851752",
            "telephone_number": "727-365-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 600",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761253",
            "telephone_number": "708-482-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJEDA",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.165148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.