Unknown Individual – Dermatology Physician, NPI 1265637995
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Oakbrook Center, 16th Street, Oak Brook, DuPage County, Illinois, 60523, United States
SUITE 410
OAK BROOK, IL 605231806
Phone: (630) 574-5860
Fax: (630) 574-5866
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-11-13 • Largest payer in this snapshot: Ortho Dermatologics, a division of Bausch Health US, LLC ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ortho Dermatologics, a division of Bausch Health US, LLC | $18 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60523)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| D E R M A T O L O G Y | IL | |
| Physician Assistant | IL | |
| Nurse Practitioner | PA | |
| - | IL | |
| - | IL | |
| Nurse Practitioner | IN | |
| Physician Assistant | IL | |
| Physician Assistant | IL | |
| General Surgery | IN |
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