ILLINOIS SKIN CENTER LLC
NPI 1588283402
Dermatology in Chicago, IL

Q: What is Illinois Skin Center LLC's NPI number?

The NPI number for Illinois Skin Center LLC is 1588283402. It was assigned to this organization in the NPPES registry on April 10, 2020.

Q: What is Illinois Skin Center LLC's specialty?

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

Active since April 10, 2020CLIA 14D2264979 · Waiver

2202 N HALSTED ST STE 1, CHICAGO, IL 60614(312) 600-5826(872) 260-5008 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 27, 2025, Feb 11, 2025, Jan 11, 2025 and 5 more (8 updates tracked since 2020).

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About Illinois Skin Center Llc NPPES

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

ILLINOIS SKIN CENTER LLC (NPI 1588283402) is a healthcare organization registered as a dermatology in Chicago, Illinois and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through July 20, 2028 and lists David Othman, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1588283402

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameILLINOIS SKIN CENTER LLC

Location Address2202 N HALSTED ST STE 1Chicago, IL 60614-3625

Mailing Address2202 N Halsted St Ste 1Chicago, IL 60614-3625 · (312) 600-5826 · Fax (872) 260-5008

Phone(312) 600-5826

Fax(872) 260-5008

Organization SubpartNo

Authorized OfficialDavid OthmanPresident And Ceo · (312) 600-5826

Enumeration DateApril 10, 2020

Last NPPES UpdateFebruary 27, 20258 updates tracked since enumeration

NPPES CertifiedFebruary 27, 2025

✔ NPI 1588283402 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 ListedNon-Pharmacy Dispensing SiteTaxonomy 332900000X

2202 N HALSTED ST STE 1, Chicago, IL 60614

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BlueCross BlueShield of Tennessee, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Illinois Skin Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Illinois Skin Center LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

David Othman, M.D., M.H.S.A

Dermatology

NPI 1760741938

2202 N HALSTED ST STE 1
Chicago, IL 60614

(312) 600-5826

✔ PECOS✔ Accepts MedicareSame address

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 Waiver 14D2264979

Illinois Skin Center · Chicago, IL

Active · expires Jul 20, 2028

CLIA Number14D2264979

Laboratory TypePhysician Office

Certificate Effective DateJuly 21, 2026

Certificate Expiration DateJuly 20, 2028

Laboratory DirectorDavid Othman

Laboratory Phone(312) 600-5826

Laboratory LocationIllinois Skin Center2202 N Halsted St - Ste 1, Chicago, IL 60614

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only 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 Illinois Skin Center LLC's NPI number?

The NPI number for Illinois Skin Center LLC is 1588283402. It was assigned to this organization in the NPPES registry on April 10, 2020.

Where is Illinois Skin Center LLC located?

Illinois Skin Center LLC is located at 2202 N Halsted St Ste 1, Chicago, IL 60614. The listed phone number is (312) 600-5826.

What is Illinois Skin Center LLC's specialty?

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

Is Illinois Skin Center LLC enrolled in Medicare?

Yes. Illinois Skin Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Illinois Skin Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Illinois Skin Center LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Illinois Skin Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2264979) is associated with this NPI, valid through July 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Illinois Skin Center LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, BlueCross BlueShield of Tennessee, Molina Healthcare, Oscar Health and Oscar Health Insurance and 5 other insurers list Illinois Skin Center LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Illinois Skin Center LLC was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.