ILLINOIS DERMATOLOGY INSTITUTE, LLC
NPI 1447613989
Clinic/Center - Medical Specialty in Park Ridge, IL
NPI Status: Active since April 01, 2016
Contact Information
1550 N NORTHWEST HWY
SUITE 300
PARK RIDGE, IL
ZIP 60068
Phone: (847) 298-1831
Fax: (847) 298-1832
- Organization
- Clinic/Center
- Medical Specialty
- Accepts Insurance
- CLIA Number: 14D1071032
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-04-2027
About ILLINOIS DERMATOLOGY INSTITUTE, LLC
This page provides the complete NPI Profile along with additional information for Illinois Dermatology Institute, Llc, a provider established in Park Ridge, Illinois operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1447613989 assigned on April 2016. The practitioner's primary taxonomy code is 261QM2500X with license number 036111710 (IL). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Steven Mandrea M.d. (Physician)
- NPI
- 1447613989
- Provider Name
- ILLINOIS DERMATOLOGY INSTITUTE, LLC
- Entity Type
- Organization
- Location Address
- 1550 N NORTHWEST HWY SUITE 300 PARK RIDGE, IL 60068
- Location Phone
- (847) 298-1831
- Location Fax
- (847) 298-1832
- Mailing Address
- 1550 N NORTHWEST HWY SUITE 300 PARK RIDGE, IL 60068
- Mailing Phone
- (847) 298-1831
- Mailing Fax
- (847) 298-1832
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-01-2016
- Last Update Date
- 04-01-2016
- 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
Clinic/Center Medical Specialty
- Taxonomy Code
- 261QM2500X
- Type
- Ambulatory Health Care Facilities
- License No.
- 036111710
- License State
- IL
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Select by Medica Bronze $0 Copay PCP Visits - EPO
- Select by Medica Bronze Share - EPO
- Select by Medica Expanded Bronze Standard - EPO
- Select by Medica Gold $0 Copay PCP Visits - EPO
- Select by Medica Gold Share - EPO
- Select by Medica Gold Standard - EPO
- Select by Medica Silver $0 Copay PCP Visits - EPO
- Select by Medica Silver Share - EPO
- Select by Medica Silver Standard - EPO
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 |
|---|---|---|---|
| 1386663631 | OTHER (01) | IL | NPI |
| 036111710 | MEDICAID (05) | IL | |
| IL2485005 | MEDICARE PIN (08) | IL |
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
- 14D1071032
- Facility Type
- Physician Office
- Certificate Effective Date
- October 05, 2025
- Certificate Expiration Date
- October 04, 2027
- Laboratory Director
- KEITH LOPATKA
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Illinois Dermatology Institute, 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 1447613989, 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 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 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 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PARK RIDGE, IL 60068
PARK RIDGE, IL 60068
PARK RIDGE, IL 60068
PARK RIDGE, IL 60068
PARK RIDGE, IL 60068
PARK RIDGE, IL 60068
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447613989, enumerated as an "organization" on April 01, 2016.
The provider is located at 1550 N NORTHWEST HWY SUITE 300 PARK RIDGE, IL 60068 and the phone number is (847) 298-1831.
Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.
The provider might be accepting Accepts: Medica, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
