Chicago Cosmetic Surgery and Dermatology SC
NPI 1407068000ActiveOrganization· Dermatology· Chicago, IL
Dermatology in Chicago, Illinois, registered in NPPES in May 2007. The authorized official on file is Carolyn Jacob, Medical Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1407068000 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 4, 2007 |
| Last updated in NPPES | Apr 14, 2026 |
| Certified by provider | Apr 14, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 036-102098 | IL |
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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