Diana Leigh Vork

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036156222 Issued in IL

Practice address

1191 Fortune Blvd Ste 2
Shiloh, IL 62269-7474

Phone

(618) 622-7546

NPI assigned

Apr 21, 2017

Last updated

Sep 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Diana Leigh Dalrymple Former name

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

Specialty

Dermatology

Education

Mayo Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro East Dermatology and Skin Cancer Center LLCGroup PAC ID 9739451956, 7 clinicians

Washington County Hospital DistrictGroup PAC ID 4880599844, shared by 4 NPIs, 21 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

81.6

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dvork@metro.emadirect.md

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

• Metro East Dermatology & Skin Cancer Center LLC

  • Dermatology Physician
  • Shiloh, IL
  • NPI 1518494996
  Medicare reassignment Care Compare group
• Mitas LLC

  dba Axis Spine and Orthopedics

  • Orthopaedic Surgery Physician
  • Shiloh, IL
  • NPI 1659967917
  NPD
• Skin Cancer Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • O'Fallon, IL
  • NPI 1699407643
  NPD

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1871028316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 FORTUNE BLVD STE 2",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697474",
            "telephone_number": "618-622-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VORK",
        "first_name": "DIANA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "64202",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036156222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "DALRYMPLE",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Rehabilitation Institute of Southern Illinois,LLC (The Rehabilitation Institute of Southern Illinois)
• Samantha An Tilley, MS, RDN, LDN
• Total Renal Care Inc (O'Fallon Dialysis)
• Sydnie Elizabeth Twillmann, PHARMD
• John L Visconti, DO
• Sheila Forrest Wagner, OTR/L
• Walgreen Co (Walgreens #07672)
• Walgreen Co. (Walgreens #7672)
• Stacy Ann Ward, RN
• Washington University Physicians in Illinois, Inc

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

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