Carla Marie Solomon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1240 N Milwaukee Ave Ste a
Libertyville, IL 60048-1307

Phone

(847) 367-5575

Fax

(847) 367-5579

NPI assigned

Apr 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Crest Hill, IL
  • NPI 1053783308
  Medicare reassignment Care Compare group
• Edgebrook Dermatology P.C.

  • Dermatology Physician
  • Rockford, IL
  • NPI 1225184948
  Medicare reassignment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Berwyn, IL
  • NPI 1629524632
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1932729472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 N MILWAUKEE AVE STE A",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481307",
            "telephone_number": "847-367-5575",
            "fax_number": "847-367-5579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 N Hunt Club Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600312635",
            "country_code": "US",
            "telephone_number": "847-855-1730",
            "fax_number": "847-855-1736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1240 N Milwaukee Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600481307",
            "country_code": "US",
            "telephone_number": "847-367-5575",
            "fax_number": "847-367-5579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Carla.Solomon@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1425 N Hunt Club Rd Ste 202",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600312635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Carla.Solomon@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1240 N Milwaukee Ave Ste B",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600481307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Carla.Solomon@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1240 N Milwaukee Ave Ste A",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600481307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adam P. Smith, M.D.
• Allison Lauren Smith, MA LCPC
• Michelle Smith
• Rachael Teal Smith, EMT-P
• Cassandra Leigh Snider, PA-C
• Mark Solomon, PSY.D.
• Linda M Sommercorn, MS, DDS, RPH
• Sonamu Wellness LLC
• Jie Song, M.D.
• Anshuman Soni, DDS

• Physician Assistant in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.