PREMIER DERMATOLOGY
NPI 1154793412
Dermatology in New Lenox, IL

NPI Status: Active since October 27, 2015

Contact Information

1890 SILVER CROSS BLVD
SUITE 505
NEW LENOX, IL
ZIP 60451
Phone: (708) 424-0656
Fax: (630) 904-0413

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  • Organization
  • Dermatology
  • CLIA Number: 14D2042214
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-06-2028

About PREMIER DERMATOLOGY

This page provides the complete NPI Profile along with additional information for Premier Dermatology, a provider established in New Lenox, Illinois operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1154793412 assigned on October 2015. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Premier Dermatology. The authorized official of this NPI record is Dr. Betsy J Wernli Md (President)

NPI
1154793412
Provider Legal Name
FOREFRONT DERMATOLOGY, S.C.
Other Organization Name
PREMIER DERMATOLOGY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1890 SILVER CROSS BLVD SUITE 505 NEW LENOX, IL 60451
Location Phone
(708) 424-0656
Location Fax
(630) 904-0413
Mailing Address
801 YORK ST MANITOWOC, WI 54220
Mailing Phone
(920) 663-9016
Mailing Fax
(630) 904-0413
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-27-2015
Last Update Date
05-17-2018
Code Navigator

A dermatologist like Premier Dermatology is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

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

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

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)
1207NS0135XAllopathic & Osteopathic Physicians

Dermatology
Procedural Dermatology

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. BETSY J WERNLI MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(920) 482-0671

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2042214
Facility Type
Physician Office
Certificate Effective Date
June 07, 2026
Certificate Expiration Date
June 06, 2028
Laboratory Director
STEVEN NEUBAUER MD
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Premier Dermatology in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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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 1154793412, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

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.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
3
Doubled → 6
Pos 8
4
Unchanged
Pos 9
1
Doubled → 2
Check
2
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 7 → 14 → 5 3 → 6 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 0 + 4 + 1 + 4 + 9 + 6 + 4 + 2 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1154793412.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
1890 SILVER CROSS BLVD, SUITE 330
NEW LENOX, IL 60451
Obstetrics & Gynecology
1890 SILVER CROSS BLVD, SUITE 330
NEW LENOX, IL 60451
Surgery
1890 SILVER CROSS BLVD, STE 560
NEW LENOX, IL 60451
Dentist
1890 SILVER CROSS BLVD, SUITE 470
NEW LENOX, IL 60451
Surgery
1890 SILVER CROSS BLVD, SUITE 410
NEW LENOX, IL 60451
Family Medicine
1890 SILVER CROSS BLVD, SUITE 570
NEW LENOX, IL 60451
Internal Medicine
1890 SILVER CROSS BLVD, SUITE 265
NEW LENOX, IL 60451
Internal Medicine
1890 SILVER CROSS BLVD, SUITE 265
NEW LENOX, IL 60451
Surgery
1890 SILVER CROSS BLVD, SUITE 410
NEW LENOX, IL 60451
Surgery
1890 SILVER CROSS BLVD, #410
NEW LENOX, IL 60451
Family Medicine
1890 SILVER CROSS BLVD, SUITE 570
NEW LENOX, IL 60451
Nurse Practitioner (Family)
1890 SILVER CROSS BLVD, ST 350
NEW LENOX, IL 60451
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1890 SILVER CROSS BLVD, PAVILLION A SUITE 560
NEW LENOX, IL 60451
Internal Medicine
1890 SILVER CROSS BLVD, SUITE 370
NEW LENOX, IL 60451
Family Medicine
1890 SILVER CROSS BLVD, SUITE 370
NEW LENOX, IL 60451
Physician Assistant
1890 SILVER CROSS BLVD
NEW LENOX, IL 60451
Physician Assistant (Surgical)
1890 SILVER CROSS BLVD, SUITE 410
NEW LENOX, IL 60451
Family Medicine
1890 SILVER CROSS BLVD, SUITE 570
NEW LENOX, IL 60451
Family Medicine
1890 SILVER CROSS BLVD, SUITE 570
NEW LENOX, IL 60451
Obstetrics & Gynecology
1890 SILVER CROSS BLVD, SUITE 210
NEW LENOX, IL 60451

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154793412, enumerated as an "organization" on October 27, 2015.

The provider is located at 1890 SILVER CROSS BLVD SUITE 505 NEW LENOX, IL 60451 and the phone number is (708) 424-0656.

Dermatology with taxonomy code 207N00000X.