Crystal Lake Dermatology SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CRYSTAL LAKE DERMATOLOGY SC

Practice address

278 Memorial Dr
Crystal Lake, IL 60014

Phone

(815) 477-9867

Fax

(815) 477-9868

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jamie So-Yung Chin, MD

Title

Physician

Phone

(815) 477-9858

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.

• Juliana Yong Hae Chyu, M.D.

  • Dermatology Physician
  • Crystal Lake, IL
  • NPI 1609972124
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1982777231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 MEMORIAL DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-477-9867",
            "fax_number": "815-477-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 MEMORIAL DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-477-9867",
            "fax_number": "815-477-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL LAKE DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "CHIN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "SO-YUNG",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "815-477-9858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cronin Medical Group, LTD.
• Margaret Crowley
• Crystal Family Dental Care
• Crystal Lake CC SCH Dist 47
• Crystal Lake Center for Chronic Pain SC
• Crystal Lake Family Dental
• Crystal Lake Family Treatment Center LTD
• Crystal Lake Family Wellness
• Crystal Lake Foot & Ankle Center LLC
• Crystal Lake Immediate Care Physicians LTD.

• Dermatology Physician in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.