SKIN CARE CENTER OF S. ILLINOIS - CENTRALIA
NPI 1467955179
Dermatology in Mount Vernon, IL

Q: What is United Skin Specialists Illinois Ltd, PC's specialty?

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

Active since March 09, 2018CLIA 24D1077017 · Certificate of Compliance

4107 S WATER TOWER PL, MOUNT VERNON, IL 62864(618) 244-0031 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 16, 2018, Mar 17, 2018, Mar 9, 2018 (3 updates tracked since 2018).

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About Skin Care Center Of S. Illinois - Centralia NPPES

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

SKIN CARE CENTER OF S. ILLINOIS - CENTRALIA (NPI 1467955179) is a healthcare organization registered as a dermatology in Mount Vernon, Illinois and active in the NPI registry since March 2018. The organization holds a CLIA Certificate of Compliance certificate valid through August 28, 2026, maintains a secondary practice location in Centralia, and lists Jim Feinstein, Preseident/coo, as its authorized official.

NPPES Registry Identity

NPI1467955179

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameUNITED SKIN SPECIALISTS ILLINOIS LTD, PC

Location Address4107 S WATER TOWER PLMount Vernon, IL 62864-6293

Mailing Address2 Carlson Pkwy N Ste 240Plymouth, MN 55447-4485 · (763) 746-0030 · Fax (763) 367-7977

Phone(618) 244-0031

Organization SubpartNo

Authorized OfficialJim FeinsteinPreseident/coo · (763) 746-0030

Enumeration DateMarch 9, 2018

Last NPPES UpdateJune 16, 20183 updates tracked since enumeration

✔ NPI 1467955179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

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.

Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X

4107 S WATER TOWER PL, Mount Vernon, IL 62864

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Other Names 2

Doing Business AsSkin Care Center Of S. Illinois - Centralia

Doing Business AsSkin Care Center Of S. Illinois - Mt. Vernon

Secondary Practice Location 1

Location 11054 Martin Luther King DrCentralia, IL 62801-3000 · Phone (618) 244-0031

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 MULTIPLE SINGLE SPECIALTY GROUP

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 24D1077017

United Skin Specialists Ltd · Plymouth, MN

Active · expires Aug 28, 2026

CLIA Number24D1077017

Laboratory TypePhysician Office

Certificate Effective DateAugust 29, 2024

Certificate Expiration DateAugust 28, 2026

Laboratory DirectorKyle Rudningen

Laboratory Phone(952) 473-1286

Laboratory LocationUnited Skin Specialists Ltd2 Carlson Parkway North, Suite 100, Plymouth, MN 55447

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNITED SKIN SPECIALISTS ILLINOIS LTD, PC

Dermatology