TINA C VENETOS MD
NPI 1841315884
Dermatology in Lake Bluff, IL

Active since March 20, 2007CLIA 14D2089854 · Certificate of Compliance
925 SHERWOOD DR, LAKE BLUFF, IL 60044(847) 234-1177(847) 234-1875 Get Directions Write a Review

NPPES record last updated: March 31, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tina C Venetos Md NPPES

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

TINA C VENETOS MD (NPI 1841315884) is a healthcare organization registered as a dermatology in Lake Bluff, Illinois and active in the NPI registry since March 2007. The organization holds a CLIA Certificate of Compliance certificate valid through January 6, 2027 and lists Tina C Venetos, President Of Northshore Dermatology, as its authorized official.

NPPES Registry Identity

NPI1841315884
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNORTHSHORE DERMATOLOGY CENTER SC
Location Address925 SHERWOOD DRLake Bluff, IL 60044-2203
Mailing Address925 Sherwood DrLake Bluff, IL 60044-2203 · (847) 234-1177 · Fax (847) 234-1875
Fax(847) 234-1875
Organization SubpartNo
Authorized OfficialTina C VenetosPresident Of Northshore Dermatology · (847) 234-1177
Enumeration DateMarch 20, 2007
Last NPPES UpdateMarch 31, 2015
✔ NPI 1841315884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in IL · 036084683
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.
925 SHERWOOD DR, Lake Bluff, IL 60044

Other Names 1

Doing Business AsTina C Venetos Md

Other Identifiers 4

Medicare PIN393200IL
Medicare UPING32656IL
Other01608107IL · Blue Cross Blue Shield
Medicare PIN575040IL

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tina C Venetos Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Tina C Venetos MD, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Dermatology
NPI 1336256437
800 N WESTMORELAND RD SUITE 100C
Lake Forest, IL 60045
(847) 234-1177
✔ PECOS✔ Accepts Medicare1.1 mi
Nurse Practitioner
NPI 1396250346
571 N RAND RD
Lake Zurich, IL 60047
(224) 415-2044
✔ PECOS13 mi
Dermatology
NPI 1366601312
1 S 210 SUMMIT AVENUE
Oakbrook Terrace, IL 60181
(630) 627-3376
✔ PECOS✔ Accepts Medicare29 mi

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 Compliance 14D2089854

Northshore Dermatology Center · Lake Bluff, IL
Active · expires Jan 6, 2027
CLIA Number14D2089854
Laboratory TypePhysician Office
Certificate Effective DateJanuary 7, 2025
Certificate Expiration DateJanuary 6, 2027
Laboratory DirectorTina C. Venetos M D
Laboratory Phone(847) 234-1177
Laboratory LocationNorthshore Dermatology Center925 Sherwood Dr, Lake Bluff, IL 60044
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.

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 Northshore Dermatology Center Sc's NPI number?

The NPI number for Northshore Dermatology Center Sc is 1841315884. It was assigned to this organization in the NPPES registry on March 20, 2007. The provider is doing business as Tina C Venetos MD.

Where is Northshore Dermatology Center Sc located?

Northshore Dermatology Center Sc is located at 925 Sherwood Dr, Lake Bluff, IL 60044. The listed phone number is (847) 234-1177.

What is Northshore Dermatology Center Sc's specialty?

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

Is Northshore Dermatology Center Sc enrolled in Medicare?

Yes. Northshore Dermatology Center Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northshore Dermatology Center Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Northshore Dermatology Center Sc, in Dermatology and Nurse Practitioner. 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, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Northshore Dermatology Center Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 14D2089854) is associated with this NPI, valid through January 6, 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 Northshore Dermatology Center Sc was last updated on March 31, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.