DERMATOLOGY
NPI 1104178144
Dermatology - Procedural Dermatology in Carbondale, IL
NPI Status: Active since October 14, 2012
Contact Information
1175 CEDAR CT
CARBONDALE
CARBONDALE, IL
ZIP 62901
Phone: (619) 549-0300
- Organization
- Dermatology
- Procedural Dermatology
About DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Dermatology, a provider established in Carbondale, Illinois operating as a Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1104178144 assigned on October 2012. The practitioner's primary taxonomy code is 207NS0135X with license number 036094335 (IL). The provider is registered as an organization and their NPI record was last updated 14 years ago. Dermatology operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Dermatology. The authorized official of this NPI record is Dr. Anup Kumar Chaudhry M.d. (Member)
- NPI
- 1104178144
- Provider Legal Name
- REVIVE SKIN INSTITUTE LLC
- Other Organization Name
- DERMATOLOGY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1175 CEDAR CT CARBONDALE CARBONDALE, IL 62901
- Location Phone
- (619) 549-0300
- Mailing Address
- 1175 CEDAR CT CARBONDALE CARBONDALE, IL 62901
- Mailing Phone
- (619) 549-0300
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-14-2012
- Last Update Date
- 10-14-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology Procedural Dermatology
- Taxonomy Code
- 207NS0135X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036094335
- License State
- IL
- Taxonomy Description
- Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | 036094335 (IL) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 036094335 | MEDICAID (05) | IL | |
| C43899 | MEDICARE UPIN (02) | IL |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104178144, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104178144, enumerated as an "organization" on October 14, 2012.
The provider is located at 1175 CEDAR CT CARBONDALE CARBONDALE, IL 62901 and the phone number is (619) 549-0300.
Dermatology with taxonomy code 207NS0135X and a focus in Procedural Dermatology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
