DERM INSTITUTE OF CHICAGO
NPI 1710531330
Dermatology in Chicago, IL
About Derm Institute Of Chicago NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERM INSTITUTE OF CHICAGO (NPI 1710531330) is a healthcare organization registered as a dermatology in Chicago, Illinois and active in the NPI registry since July 2019. The organization holds 4 active CLIA laboratory certificates, maintains 3 additional practice locations, and lists Marc Wezowski, Managing Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Secondary Practice Locations 3
Group Practice 2
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Derm Institute Of Chicago is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Derm Institute Of Chicago, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
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 4
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 14D2299279
Derm Institute Of Chicago · Chicago, ILCertificate of Compliance 14D2191022
Derm Institute Of Chicago · Chicago, ILCertificate of Compliance 14D2230163
Derm Institute Of Chicago · Hinsdale, ILCertificate of Compliance 14D2238224
Derm Institute Of Chicago · Skokie, ILFrequently 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 Jordan C. Carqueville, MD LLC's NPI number?
The NPI number for Jordan C. Carqueville, MD LLC is 1710531330. It was assigned to this organization in the NPPES registry on July 31, 2019. The provider is doing business as Derm Institute Of Chicago.
Where is Jordan C. Carqueville, MD LLC located?
Jordan C. Carqueville, MD LLC is located at 737 N Michigan Ave Ste 720, Chicago, IL 60611. The listed phone number is (312) 319-1978.
What is Jordan C. Carqueville, MD LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Jordan C. Carqueville, MD LLC enrolled in Medicare?
Yes. Jordan C. Carqueville, MD LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jordan C. Carqueville, MD LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians, all in Dermatology, reassign their Medicare billing to Jordan C. Carqueville, MD 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. Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Jordan C. Carqueville, MD LLC hold CLIA laboratory certificates?
Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Jordan C. Carqueville, MD LLC was last updated on January 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Derm Institute Of Chicago · NPI 1710531330
Dermatology organization in Chicago, Illinois. Organization record, active in the CMS NPPES registry since July 31, 2019.
## Identity
- **NPI:** 1710531330 (Entity type: Organization)
- **Enumerated:** July 31, 2019
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Legal business name:** Jordan C. Carqueville, Md Llc
- **Organization subpart:** No
- **Authorized official:** Marc Wezowski, MANAGING DIRECTOR
## Practice location
- **Address:** 737 N MICHIGAN AVE STE 720, Chicago, IL 60611-6661
- **Phone:** (312) 319-1978 · **Fax:** (312) 262-7791
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 4 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 11, 2025
- **CLIA laboratory certificates:** 4 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1710531330) · Data from the CMS NPPES public registry.