| NPI | 1134664402 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2016-12-22 |
| Last Updated | 2022-09-09 |
| Authorized Official | Amy Derick Medical Director Phone: 8473818899 |
| Mailing Address | Po Box 6685 Carol Stream, IL 60197-6685 United States Phone: (847) 381-8899 | Fax: (547) 381-8999 📍 View Map |
| Primary Practice Address | 525 E Congress Parkway, Suite 200 Crystal Lake, IL 60014 United States Phone: (847) 381-8899 | Fax: (847) 381-8999 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332900000X – Non-Pharmacy Dispensing Site | - | - |
| Yes | 207N00000X – Dermatology | IL | 36112935 |
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About NPI 1134664402
Derick Dermatology, Pllc is an organization registered in the CMS NPPES NPI Registry with NPI number 1134664402. The primary specialty listed is Dermatology. The organization is located in Crystal Lake, IL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2016-12-22. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1134664402?
NPI 1134664402 belongs to Derick Dermatology, Pllc, a Dermatology in Crystal Lake, IL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1134664402 active?
The current status of NPI 1134664402 in the NPPES registry is Active. The record was last updated on 2022-09-09.
What specialty is NPI 1134664402?
NPI 1134664402 is classified under the taxonomy Dermatology. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1134664402?
You can verify NPI 1134664402 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1134664402?
The primary practice address on file for NPI 1134664402 is 525 E Congress Parkway, Crystal Lake, IL 60014. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1134664402 issued?
NPI 1134664402 was first issued (enumerated) on 2016-12-22. The NPPES record was last updated on 2022-09-09.
Practice Location Map
Derick Dermatology, Pllc is located at 525 E Congress Parkway, Crystal Lake, IL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Derick Dermatology, Pllc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1134664402. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dermatology | 36112935 | IL |