Charles Dobbin Connor, M.D.

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Practice address

22 Professional Park Dr
Maryville, IL 62062-5669

Phone

(618) 288-0998

Fax

(618) 288-9934

NPI assigned

May 3, 2006

Last updated

Dec 27, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Dermatology Care Center, LTD.

  • Dermatology Physician
  • Maryville, IL
  • NPI 1619271939
  Authorized official Same address or phone

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1992763353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PROFESSIONAL PARK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625669",
            "telephone_number": "618-288-0998",
            "fax_number": "618-288-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PROFESSIONAL PARK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625669",
            "telephone_number": "618-288-0998",
            "fax_number": "618-288-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOR",
        "first_name": "CHARLES",
        "middle_name": "DOBBIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lindsay K Cobb, MSN, APRN,FNP-BC
• Carl J Collignon, RPH
• Collins Pain Management, S.C.
• Gregory Collins, MD
• Compass Community Counseling
• Larry Copp, M.S., CADC
• Cornerstone Counseling, P.C.
• Counselors Associates
• Jasmine Cowan, DNP, APRN, PMHNP-BC
• Abigail Jacqueline Crabtree, PA

• Procedural Dermatology Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• Procedural Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.