Unknown Individual – Dermatology Physician, NPI 1720061526
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
120 OAK BROOK CENTER MALL
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 41 Open Payments records for all available years, with a total value of $845.
Total Amount is formed as General ($845) + Research ($0) + Ownership ($0) = $845.
Last reported payment date: 2023-12-07 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($239).
Total Amount
$845
General + Research + Ownership
Payments
41
Total payment records
General Amount
$845
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-07
Latest reported date
Top Companies
Largest payers in this snapshot
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,456 | 240 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 636 | 469 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 456 | 359 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 454 | 318 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 167 | 138 | $0 |
Insurance plans in this area (ZIP 60523)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | IL | 17003 | Destruction of 2-14 skin growths | 2395 | 355 |
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 | |
| - | IL |
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