NPIMap

Organization Active NPI

Des Plaines Dermatology, LTD.

  • Dermatology Physician
  • Des Plaines, IL
National Provider Identifier
1902127194
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DES PLAINES DERMATOLOGY, LTD.
Practice address
1455 E Golf Rd
Suite 104
Des Plaines, IL 60016-1250
Phone
(773) 935-4700
Fax
(773) 935-2595
NPI assigned
Jun 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Authorized official

Name
Dr. Jeanne Hoag, MD
Title
Owner
Phone
(847) 518-9381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1455 E Golf Rd
Suite 104
Des Plaines, IL 60016-1250

Mailing address

1455 E Golf Rd
Suite 104
Des Plaines, IL 60016-1250
Phone (773) 935-4700

Other identifiers 1

IdentifierTypeStateIssuer
1174529762OtherILNPI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2013792Des Plaines Dermatology1455 E Golf Rd, Sgte 104, Des Plaines, IL 60016Provider-performed microscopySep 23, 2026

National Provider Directory

National Provider Directory

Locations

1455 E Golf Rd
Ste 104
Des Plaines, IL 60016
Phone (773) 935-4700

Practitioners & affiliated clinicians

Practitioners 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1902127194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E GOLF RD",
            "address_2": "SUITE 104",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161250",
            "telephone_number": "773-935-4700",
            "fax_number": "773-935-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E GOLF RD",
            "address_2": "SUITE 104",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161250",
            "telephone_number": "773-935-4700",
            "fax_number": "773-935-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES PLAINES DERMATOLOGY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "HOAG",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-518-9381",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": "NPI",
            "identifier": "1174529762",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.