Dermatology and Skin Cancer Center
NPI 1093596652ActiveOrganization· Dermatology· Bloomington, IL
Dermatology in Bloomington, Illinois, registered in NPPES in October 2023. The authorized official on file is Adrienne Schupbach, MD, Md/Practice Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1093596652 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 10, 2023 |
| Last updated in NPPES | Dec 17, 2024 |
| Certified by provider | Dec 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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