MIDWEST DERMPATH LLC
NPI 1194591529
Pathology - Dermatopathology in Bartonville, IL
NPI Status: Active since November 27, 2023
Contact Information
409 KELLER ST
BARTONVILLE, IL
ZIP 61607
Phone: (309) 404-6583
- Organization
- Pathology
- Dermatopathology
- CLIA Number: 14D2293395
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 03-04-2027
About MIDWEST DERMPATH LLC
This page provides the complete NPI Profile along with additional information for Midwest Dermpath Llc, a provider established in Bartonville, Illinois operating as a Pathology, focusing in dermatopathology . The healthcare provider is registered in the NPI registry with number 1194591529 assigned on November 2023. The practitioner's primary taxonomy code is 207ZD0900X. The provider is registered as an organization and their NPI record was last updated 2 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 authorized official of this NPI record is Tesfu Hailu Md (Lab Director)
- NPI
- 1194591529
- Provider Name
- MIDWEST DERMPATH LLC
- Entity Type
- Organization
- Location Address
- 409 KELLER ST BARTONVILLE, IL 61607
- Location Phone
- (309) 404-6583
- Mailing Address
- 409 KELLER ST BARTONVILLE, IL 61607
- Mailing Phone
- (309) 404-6583
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-27-2023
- Last Update Date
- 01-31-2024
- 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
Pathology Dermatopathology
- Taxonomy Code
- 207ZD0900X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy.
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 | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology |
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.
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
- 14D2293395
- Facility Type
- Independent
- Certificate Effective Date
- March 05, 2025
- Certificate Expiration Date
- March 04, 2027
- Laboratory Director
- TESFU L. HAILU
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Midwest Dermpath Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high 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 1194591529, we treat the final digit (9) 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 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
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 61 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194591529, enumerated as an "organization" on November 27, 2023.
The provider is located at 409 KELLER ST BARTONVILLE, IL 61607 and the phone number is (309) 404-6583.
Pathology with taxonomy code 207ZD0900X and a focus in Dermatopathology.
