SKIN CARE CENTER OF SOUTHERN IL LLC
NPI 1669599841
Dermatology - Dermatopathology in Mount Vernon, IL

Active since March 23, 2007
4107 S WATER TOWER PL, MOUNT VERNON, IL 62864(618) 244-0031(618) 244-0056 Get Directions Write a Review

NPPES record last updated: June 25, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Skin Care Center Of Southern Il Llc NPPES

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

SKIN CARE CENTER OF SOUTHERN IL LLC (NPI 1669599841) is a healthcare organization registered as a dermatopathology in Mount Vernon, Illinois and active in the NPI registry since March 2007. The organization lists George Thomas Nahass, Owner, as its authorized official.

NPPES Registry Identity

NPI1669599841
Entity TypeOrganization
Primary Taxonomy207ND0900X
Legal Business NameSKIN CARE CENTER OF SOUTHERN IL LLC
Location Address4107 S WATER TOWER PLMount Vernon, IL 62864-6293
Mailing Address4107 S Water Tower PlMount Vernon, IL 62864-6293 · (618) 244-0031 · Fax (618) 244-0056
Fax(618) 244-0056
Organization SubpartNo
Authorized OfficialGeorge Thomas NahassOwner · (618) 244-0031
Enumeration DateMarch 23, 2007
Last NPPES UpdateJune 25, 2013
NPI 1669599841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatology · DermatopathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ND0900X
License Licensed in IL · 036094700
Definition

A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.

4107 S WATER TOWER PL, Mount Vernon, IL 62864

Other Identifiers 3

OtherCH5023IL · Medicare Railroad
Medicare UPIN605050IL
Medicaid152566974412IL

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

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.

Dermatology
4107 S WATER TOWER PL
MOUNT VERNON, IL 62864
Nurse Practitioner (Family)
4107 S WATER TOWER PL
MOUNT VERNON, IL 62864
Dermatology
4107 S WATER TOWER PL
MOUNT VERNON, IL 62864
Nurse Practitioner (Family)
4107 S WATER TOWER PL
MOUNT VERNON, IL 62864
Physician Assistant (Medical)
4107 S WATER TOWER PL
MOUNT VERNON, IL 62864

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 Skin Care Center Of Southern Il LLC's NPI number?

The NPI number for Skin Care Center Of Southern Il LLC is 1669599841. It was assigned to this organization in the NPPES registry on March 23, 2007.

Where is Skin Care Center Of Southern Il LLC located?

Skin Care Center Of Southern Il LLC is located at 4107 S Water Tower Pl, Mount Vernon, IL 62864. The listed phone number is (618) 244-0031.

What is Skin Care Center Of Southern Il LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

When was this NPI record last updated?

The NPPES record for Skin Care Center Of Southern Il LLC was last updated on June 25, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.