MD SKINCENTER
NPI 1932437290
Dermatology in Rockford, IL

Active since November 25, 2009
1235 N MULFORD RD, STE. 205, ROCKFORD, IL 61107(815) 484-9900(815) 487-4949 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 30, 2023, Jul 13, 2016 (2 updates tracked since 2016).

About Md Skincenter NPPES

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

MD SKINCENTER (NPI 1932437290) is a healthcare organization registered as a dermatology in Rockford, Illinois and active in the NPI registry since November 2009. The organization lists Andrew I. Jun, President, as its authorized official.

NPPES Registry Identity

NPI1932437290
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSURGICAL SERVICES OF ILLINOIS, SC
Location Address1235 N MULFORD RD, STE. 205Rockford, IL 61107-3879
Mailing Address1235 N Mulford Rd, Ste. 205Rockford, IL 61107-3879 · (815) 484-9900 · Fax (815) 487-4949
Fax(815) 487-4949
Organization SubpartNo
Authorized OfficialAndrew I. JunPresident · (815) 484-9900
Enumeration DateNovember 25, 2009
Last NPPES UpdateJanuary 30, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 30, 2023
✔ NPI 1932437290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 12

★ 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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedOtolaryngology · Pediatric OtolaryngologyTaxonomy 207YP0228X
Also ListedOtolaryngology · Facial Plastic SurgeryTaxonomy 207YS0123X
Also ListedOtolaryngology · Otolaryngic AllergyTaxonomy 207YX0602X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
1235 N MULFORD RD, Rockford, IL 61107

Other Names 1

Doing Business AsMd Skincenter

Other Identifiers 1

OtherIL2884Medicare Id

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

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to MD Skincenter, which bills Medicare for the services they deliver. Of these, 7 practice at this address. They are listed nearest first.

Clinicians, nearest first (7)

Otolaryngology
NPI 1841270717
1235 N MULFORD RD STE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1164875852
1235 N MULFORD RD SUITE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1265118087
1235 N MULFORD RD STE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1407517311
1235 N MULFORD RD STE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1902995087
1235 N MULFORD RD STE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1477745255
1235 N MULFORD RD SUITE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1629899893
1235 N MULFORD RD STE 205
Rockford, IL 61107
(815) 484-9900
✔ PECOS✔ Accepts MedicareSame address

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 14D1074608

MD Skincenter Surgical Services Of Illinois, Sc · Rockford, IL
Expired · Sep 30, 2026
CLIA Number14D1074608
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorAndrew I. Jun
Laboratory Phone(815) 484-9900
Laboratory LocationMD Skincenter Surgical Services Of Illinois, Sc1235 N Mulford Rd, Suite 205, Rockford, IL 61107
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 Surgical Services Of Illinois, Sc's NPI number?

The NPI number for Surgical Services Of Illinois, Sc is 1932437290. It was assigned to this organization in the NPPES registry on November 25, 2009. The provider is doing business as MD Skincenter.

Where is Surgical Services Of Illinois, Sc located?

Surgical Services Of Illinois, Sc is located at 1235 N Mulford Rd Ste. 205, Rockford, IL 61107. The listed phone number is (815) 484-9900.

What is Surgical Services Of Illinois, Sc's specialty?

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

Is Surgical Services Of Illinois, Sc enrolled in Medicare?

Yes. Surgical Services Of Illinois, Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Surgical Services Of Illinois, Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Surgical Services Of Illinois, Sc. 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. The largest specialties are Nurse Practitioner (5), Dermatology (1) and Otolaryngology (1). Of these, 7 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Surgical Services Of Illinois, Sc accept?

Health plans from Quartz list Surgical Services Of Illinois, Sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Surgical Services Of Illinois, Sc was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.