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CHICAGO COSMETIC SURGERY AND DERMATOLOGY SC
NPI 1407068000
Dermatology in Chicago, IL

Active since May 04, 2007
515 N STATE ST STE 900, CHICAGO, IL 60654(312) 245-9965(312) 245-9964 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 14, 2026, Jul 18, 2019 (2 updates tracked since 2019).

About Chicago Cosmetic Surgery And Dermatology Sc NPPES

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

CHICAGO COSMETIC SURGERY AND DERMATOLOGY SC (NPI 1407068000) is a healthcare organization registered as a dermatology in Chicago, Illinois and active in the NPI registry since May 2007. The organization lists Carolyn Jacob, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1407068000
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCHICAGO COSMETIC SURGERY AND DERMATOLOGY SC
Location Address515 N STATE ST STE 900Chicago, IL 60654-9104
Mailing Address515 N State St Ste 900Chicago, IL 60654-9104 · (312) 245-9965 · Fax (312) 245-9964
Phone(312) 245-9965
Fax(312) 245-9964
Organization SubpartNo
Authorized OfficialCarolyn JacobMedical Director · (312) 245-9965
Enumeration DateMay 4, 2007
Last NPPES UpdateApril 14, 20262 updates tracked since enumeration
NPPES CertifiedApril 14, 2026
✔ NPI 1407068000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in IL · 036-102098
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.
515 N STATE ST STE 900, Chicago, IL 60654
Open in Google Maps ↗

Other Identifiers 1

Other1634805IL · Blue Cross Blue Shield

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chicago Cosmetic Surgery And Dermatology Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Chicago Cosmetic Surgery And Dermatology Sc, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Carolyn Jacob, MD
Dermatology
NPI 1265498083
515 N STATE ST STE 900
Chicago, IL 60654
(312) 245-9965
✔ PECOS✔ Accepts Medicare0.1 mi
Joy Tao, MD
Dermatology
NPI 1992365696
5000 S 5TH AVE
Hines, IL 60141
(708) 202-8387
✔ PECOS✔ Accepts Medicare11 mi
Toral Patel, MD
Dermatology
NPI 1346409919
1801 S HIGHLAND AVE STE 130
Lombard, IL 60148
(630) 286-5050
✔ PECOS✔ Accepts Medicare20 mi
Jennifer Croix, MD, PHD
Dermatology
NPI 1144596628
40 SKOKIE BLVD STE 500
Northbrook, IL 60062
(224) 282-7800
✔ PECOS✔ Accepts Medicare20 mi
Solomiya Grushchak, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1588168108
200 W ARBOR DR
San Diego, CA 92103
(800) 926-8273
✔ PECOS✔ Accepts Medicare1,734 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Compliance 14D1029865

Chicago Cosmetic Surgery & Dermatology · Chicago, IL
Expired · Sep 30, 2026
CLIA Number14D1029865
Laboratory TypePhysician Office
Certificate Effective DateJuly 3, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorCarolyn I. Jacob MD
Laboratory Phone(312) 245-9965
Laboratory LocationChicago Cosmetic Surgery & Dermatology515 N State - Ste 900, Chicago, IL 60654
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Chicago Cosmetic Surgery And Dermatology Sc's NPI number?

The NPI number for Chicago Cosmetic Surgery And Dermatology Sc is 1407068000. It was assigned to this organization in the NPPES registry on May 4, 2007.

Where is Chicago Cosmetic Surgery And Dermatology Sc located?

Chicago Cosmetic Surgery And Dermatology Sc is located at 515 N State St Ste 900, Chicago, IL 60654. The listed phone number is (312) 245-9965.

What is Chicago Cosmetic Surgery And Dermatology Sc's specialty?

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

Is Chicago Cosmetic Surgery And Dermatology Sc enrolled in Medicare?

Yes. Chicago Cosmetic Surgery And Dermatology Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Chicago Cosmetic Surgery And Dermatology Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Chicago Cosmetic Surgery And Dermatology Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (4) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Chicago Cosmetic Surgery And Dermatology Sc was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.