Elderderm SC
NPI 1245577667ActiveOrganization· Dermatology· Chicago, IL
Dermatology in Chicago, Illinois, registered in NPPES in January 2013. The authorized official on file is Scott Brent Phillips, M.D., President / Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1245577667 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 4, 2013 |
| Last updated in NPPES | Jul 18, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 36-087861 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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