ASSOCIATES IN DERMATOLOGY SC
NPI 1689863904
Dermatology in Bloomington, IL

Active since October 23, 2007CLIA 14D0432268 · Certificate of Compliance
1404 EASTLAND DRIVE, SUITE 204, BLOOMINGTON, IL 61701(309) 662-8813(309) 662-6835 Get Directions Write a Review

NPPES record last updated: May 24, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Associates In Dermatology Sc NPPES

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

ASSOCIATES IN DERMATOLOGY SC (NPI 1689863904) is a healthcare organization registered as a dermatology in Bloomington, Illinois and active in the NPI registry since October 2007. The organization holds a CLIA Certificate of Compliance certificate valid through October 31, 2026 and lists Jennifer Marie Fiorini, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1689863904
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameASSOCIATES IN DERMATOLOGY SC
Location Address1404 EASTLAND DRIVE, SUITE 204Bloomington, IL 61701-3532
Mailing Address1404 Eastland Drive, Suite 204Bloomington, IL 61701-3532 · (309) 662-8813 · Fax (309) 662-6835
Fax(309) 662-6835
Organization SubpartNo
Authorized OfficialJennifer Marie FioriniPractice Manager · (309) 662-8813
Enumeration DateOctober 23, 2007
Last NPPES UpdateMay 24, 2024
NPPES CertifiedMay 24, 2024
NPI 1689863904 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.

1404 EASTLAND DRIVE, Bloomington, IL 61701

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 14D0432268

Associates In Dermatology, Sc · Bloomington, IL
Active · expires Oct 31, 2026
CLIA Number14D0432268
Laboratory TypePhysician Office
Certificate Effective DateNovember 1, 2024
Certificate Expiration DateOctober 31, 2026
Laboratory DirectorThomas R. Brander
Laboratory Phone(309) 662-8813
Laboratory LocationAssociates In Dermatology, Sc1404 Eastland Dr - Suite 204, Bloomington, IL 61701
CLIA data matches this NPI record on: Address Name Phone
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 6

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

Surgery
1404 EASTLAND DRIVE, SUITE 104
BLOOMINGTON, IL 61701
Audiologist
1404 EASTLAND DRIVE, SUITE 203
BLOOMINGTON, IL 61701
Dermatology
1404 EASTLAND DRIVE, SUITE 204
BLOOMINGTON, IL 61701
Dermatology
1404 EASTLAND DRIVE, SUITE 204
BLOOMINGTON, IL 61701
Dermatology
1404 EASTLAND DRIVE, SUITE 204
BLOOMINGTON, IL 61701
Clinic/Center
1404 EASTLAND DRIVE, STE 101
BLOOMINGTON, IL 61701

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 Associates In Dermatology Sc's NPI number?

The NPI number for Associates In Dermatology Sc is 1689863904. It was assigned to this organization in the NPPES registry on October 23, 2007.

Where is Associates In Dermatology Sc located?

Associates In Dermatology Sc is located at 1404 Eastland Drive Suite 204, Bloomington, IL 61701. The listed phone number is (309) 662-8813.

What is Associates In Dermatology Sc's specialty?

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

Does Associates In Dermatology Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 14D0432268) is associated with this NPI, valid through October 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Associates In Dermatology Sc was last updated on May 24, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.