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DERMATOLOGY PHYSICIANS SC
NPI 1063978138
Dermatology in Chicago, IL

Active since February 13, 2019CLIA 14D2244062 · Waiver
680 N LAKE SHORE DR STE 1208, CHICAGO, IL 60611(312) 483-4397 Get Directions Write a Review

NPPES record last updated: March 30, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 30, 2020, Feb 13, 2019 (2 updates tracked since 2019).

About Dermatology Physicians Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERMATOLOGY PHYSICIANS SC (NPI 1063978138) is a healthcare organization registered as a dermatology in Chicago, Illinois and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through November 28, 2027 and lists Motunrayo Adisa, Owner, as its authorized official.

NPPES Registry Identity

NPI1063978138
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY PHYSICIANS SC
Location Address680 N LAKE SHORE DR STE 1208Chicago, IL 60611-8701
Mailing Address640 N Wells St Apt 1003Chicago, IL 60654-3958 · (773) 875-2029
Phone(312) 483-4397
Organization SubpartNo
Authorized OfficialMotunrayo AdisaOwner · (773) 875-2029
Enumeration DateFebruary 13, 2019
Last NPPES UpdateMarch 30, 20202 updates tracked since enumeration
NPPES CertifiedMarch 30, 2020
✔ NPI 1063978138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
680 N LAKE SHORE DR STE 1208, Chicago, IL 60611
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2244062

Dermatology Physicians Sc · Chicago, IL
Active · expires Nov 28, 2027
CLIA Number14D2244062
Laboratory TypePhysician Office
Certificate Effective DateNovember 29, 2025
Certificate Expiration DateNovember 28, 2027
Laboratory DirectorMotunrayo Adisa
Laboratory Phone(312) 483-4397
Laboratory LocationDermatology Physicians Sc60 E Delaware Pl - Ste 1450, Chicago, IL 60611
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dermatology Physicians Sc's NPI number?

The NPI number for Dermatology Physicians Sc is 1063978138. It was assigned to this organization in the NPPES registry on February 13, 2019.

Where is Dermatology Physicians Sc located?

Dermatology Physicians Sc is located at 680 N Lake Shore Dr Ste 1208, Chicago, IL 60611. The listed phone number is (312) 483-4397.

What is Dermatology Physicians Sc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Dermatology Physicians Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2244062) is associated with this NPI, valid through November 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermatology Physicians Sc was last updated on March 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.