Radiant Dermatology, LTD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RADIANT DERMATOLOGY, LTD

Practice address

1740 Mediterranean Dr Ste 102
Sycamore, IL 60178-3191

Phone

(815) 981-4990

Fax

(815) 517-0064

NPI assigned

Nov 6, 2014

Last updated

Feb 23, 2015By 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

Amanda FriedrichsNPI 1730281965

Title

Owner/Ceo

Phone

(815) 981-4990

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Amanda Friedrichs, MD

  • Dermatology Physician
  • Sycamore, IL
  • NPI 1730281965
  Authorized official Same address or phone

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1871999680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 MEDITERRANEAN DR STE 102",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783191",
            "telephone_number": "815-981-4990",
            "fax_number": "815-517-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 MEDITERRANEAN DR STE 102",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783191",
            "telephone_number": "815-981-4990",
            "fax_number": "815-517-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT DERMATOLOGY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "FRIEDRICHS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "815-981-4990"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proactive Chiropractic & Laser Center, LLC
• Professional Services for Anxiety-Related Disorders, LLC (OCD & Anxiety Treatment Specialists)
• Professional Services in Health Psychology, LTD (LivingRite, The Center for Behavioral Health, LTD)
• Grayce Quick
• Sara Louise Quincer, MA, LCPC
• Radiologists LTD
• Gina Louise Raimondi, L.C.S.W.
• Winston D Rajendram, M.D.
• Raneem Rajjoub
• Periakaruppan Ramanathan, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.