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LAKESIDE DERMATOLOGY
NPI 1508252875
Dermatology in Libertyville, IL

Active since April 13, 2015CLIA 14D0413174 · Certificate of Compliance
1240 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048(847) 367-5575(847) 367-5579 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 15, 2021, Oct 30, 2019 (2 updates tracked since 2019).

About Lakeside Dermatology NPPES

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

LAKESIDE DERMATOLOGY (NPI 1508252875) is a healthcare organization registered as a dermatology in Libertyville, Illinois and active in the NPI registry since April 2015. The organization holds a CLIA Certificate of Compliance certificate valid through December 22, 2027 and lists Martha P Arroyo, Owner, as its authorized official.

NPPES Registry Identity

NPI1508252875
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLAKESIDE DERMATOLOGY
Location Address1240 N MILWAUKEE AVELibertyville, IL 60048-1307
Mailing Address1240 N Milwaukee AveLibertyville, IL 60048-1307 · (847) 367-5575 · Fax (847) 367-5579
Phone(847) 367-5575
Fax(847) 367-5579
Organization SubpartNo
Authorized OfficialMartha P ArroyoOwner · (847) 367-5575
Enumeration DateApril 13, 2015
Last NPPES UpdateDecember 15, 20212 updates tracked since enumeration
NPPES CertifiedDecember 15, 2021
✔ NPI 1508252875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in IL · 036.114928
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.
1240 N MILWAUKEE AVE, Libertyville, IL 60048
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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 of Compliance 14D0413174

Lakeside Dermatology, A Forefront Dermatology Prac · Libertyville, IL
Active · expires Dec 22, 2027
CLIA Number14D0413174
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorMartha Arroyo
Laboratory Phone(920) 663-9146
Laboratory LocationLakeside Dermatology, A Forefront Dermatology Prac1240 N Milwaukee Ave - Suite A, Libertyville, IL 60048
CLIA data matches this NPI record on: Address Name
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 Lakeside Dermatology's NPI number?

The NPI number for Lakeside Dermatology is 1508252875. It was assigned to this organization in the NPPES registry on April 13, 2015.

Where is Lakeside Dermatology located?

Lakeside Dermatology is located at 1240 N Milwaukee Ave, Libertyville, IL 60048. The listed phone number is (847) 367-5575.

What is Lakeside Dermatology's specialty?

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

Does Lakeside Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 14D0413174) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lakeside Dermatology was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.