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CONRAD PETERSEN DERMATOLOGY SC
NPI 1487116240
Dermatology in Chicago, IL

Active since April 02, 2019CLIA 14D2180787 · Microscopy
2845 N SHERIDAN, CHICAGO, IL 60657(773) 832-7443(773) 295-4126 Get Directions Write a Review

NPPES record last updated: March 19, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 19, 2020, Dec 13, 2019, Apr 2, 2019 (3 updates tracked since 2019).

About Conrad Petersen Dermatology Sc NPPES

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

CONRAD PETERSEN DERMATOLOGY SC (NPI 1487116240) is a healthcare organization registered as a dermatology in Chicago, Illinois and active in the NPI registry since April 2019. The organization holds a CLIA Microscopy certificate valid through March 18, 2028 and lists Erin Petersen, Owner, as its authorized official.

NPPES Registry Identity

NPI1487116240
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCONRAD PETERSEN DERMATOLOGY SC
Location Address2845 N SHERIDANChicago, IL 60657
Mailing Address2845 N SheridanChicago, IL 60657 · (773) 832-7443 · Fax (773) 295-4126
Phone(773) 832-7443
Fax(773) 295-4126
Organization SubpartNo
Authorized OfficialErin PetersenOwner · (314) 518-0403
Enumeration DateApril 2, 2019
Last NPPES UpdateMarch 19, 20203 updates tracked since enumeration
NPPES CertifiedMarch 19, 2020
✔ NPI 1487116240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
2845 N SHERIDAN, Chicago, IL 60657
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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

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 for Provider-Performed Microscopy Procedures (PPMP) 14D2180787

Conrad Petersen Dermatology Forefront Dermatology · Chicago, IL
Active · expires Mar 18, 2028
CLIA Number14D2180787
Laboratory TypePhysician Office
Certificate Effective DateMarch 19, 2026
Certificate Expiration DateMarch 18, 2028
Laboratory DirectorErin K. Peterson
Laboratory Phone(773) 832-7443
Laboratory LocationConrad Petersen Dermatology Forefront Dermatology331 W Surf St - Ste 700, Chicago, IL 60657
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Conrad Petersen Dermatology Sc's NPI number?

The NPI number for Conrad Petersen Dermatology Sc is 1487116240. It was assigned to this organization in the NPPES registry on April 2, 2019.

Where is Conrad Petersen Dermatology Sc located?

Conrad Petersen Dermatology Sc is located at 2845 N Sheridan, Chicago, IL 60657. The listed phone number is (773) 832-7443.

What is Conrad Petersen Dermatology Sc's specialty?

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

Does Conrad Petersen Dermatology Sc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D2180787) is associated with this NPI, valid through March 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Conrad Petersen Dermatology Sc was last updated on March 19, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.