NORTHSIDE DERMATOLOGY, S.C.
NPI 1861943888
Clinic/Center - Medical Specialty in Chicago, IL

Q: What is Northside Dermatology, S.C.'s NPI number?

The NPI number for Northside Dermatology, S.C. is 1861943888. It was assigned to this organization in the NPPES registry on October 14, 2016.

Q: What is Northside Dermatology, S.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Active since October 14, 2016

1663 W CARMEN AVE, CHICAGO, IL 60640(312) 420-7409 Get Directions Write a Review

NPPES record last updated: April 20, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Apr 20, 2020, Oct 30, 2016, Oct 14, 2016 (3 updates tracked since 2016).

On this page

About Northside Dermatology, S.c. NPPES

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

NORTHSIDE DERMATOLOGY, S.C. (NPI 1861943888) is a healthcare organization registered as a medical specialty in Chicago, Illinois and active in the NPI registry since October 2016. The organization lists James A Ida, Practice Owner, as its authorized official.

NPPES Registry Identity

NPI1861943888

Entity TypeOrganization

Primary Taxonomy261QM2500X

Legal Business NameNORTHSIDE DERMATOLOGY, S.C.

Location Address1663 W CARMEN AVEChicago, IL 60640-2701

Mailing Address1663 W Carmen AveChicago, IL 60640-2701

Phone(312) 420-7409

Organization SubpartNo

Authorized OfficialJames A IdaPractice Owner · (773) 293-7500

Enumeration DateOctober 14, 2016

Last NPPES UpdateApril 20, 20203 updates tracked since enumeration

NPPES CertifiedApril 20, 2020

✔ NPI 1861943888 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM2500X

License✔ Licensed in IL · 036.132972

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

1663 W CARMEN AVE, Chicago, IL 60640

Open in Google Maps ↗

Other Providers at the Same Location NPPES

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

DR. JAMES A IDA JR. MD

Dermatology

1663 W CARMEN AVE
CHICAGO, IL 60640

Cook County (773) 293-7500

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 Northside Dermatology, S.C.'s NPI number?

The NPI number for Northside Dermatology, S.C. is 1861943888. It was assigned to this organization in the NPPES registry on October 14, 2016.

Where is Northside Dermatology, S.C. located?

Northside Dermatology, S.C. is located at 1663 W Carmen Ave, Chicago, IL 60640. The listed phone number is (312) 420-7409.

What is Northside Dermatology, S.C.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for Northside Dermatology, S.C. was last updated on April 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.