DR. NICOLE ANN HARTSOUGH M.D.
NPI 1962400382
Dermatology in Loves Park, IL

Active since July 10, 2005PECOS Enrolled
7402 E RIVERSIDE BLVD, LOVES PARK, IL 61111(815) 226-9642(815) 226-9672 Get Directions Write a Review

NPPES record last updated: October 18, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Nicole Ann Hartsough M.d. NPPES

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

DR. NICOLE ANN HARTSOUGH M.D. (NPI 1962400382) is an individual dermatology provider in Loves Park, Illinois and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962400382
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameDR. NICOLE ANN HARTSOUGHCredential: M.D.
Location Address7402 E RIVERSIDE BLVDLoves Park, IL 61111-5630
Mailing Address7402 E Riverside BlvdLoves Park, IL 61111-5630 · (815) 226-9642 · Fax (815) 226-9672
Fax(815) 226-9672
Sole ProprietorYes
Enumeration DateJuly 10, 2005
Last NPPES UpdateOctober 18, 2007
NPI 1962400382 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.

7402 E RIVERSIDE BLVD, Loves Park, IL 61111

Other Identifiers 2

Medicare ID-Type UnspecifiedK17059IL
Medicare UPINC45636IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Nicole Ann Hartsough M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Physician Assistant (Medical)
7402 E RIVERSIDE BLVD
LOVES PARK, IL 61111
Orthopaedic Surgery (Orthopaedic Trauma)
7402 E RIVERSIDE BLVD
LOVES PARK, IL 61111
Specialist
7402 E RIVERSIDE BLVD
LOVES PARK, IL 61111
Nurse Practitioner (Family)
7402 E RIVERSIDE BLVD
LOVES PARK, IL 61111
Durable Medical Equipment & Medical Supplies (Customized Equipment)
7402 E RIVERSIDE BLVD
LOVES PARK, IL 61111
Dermatology
7402 E RIVERSIDE BLVD
LOVES PARK, IL 61111

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 Nicole Hartsough's NPI number?

The NPI number for Nicole Hartsough is 1962400382. It was assigned to this individual provider in the NPPES registry on July 10, 2005.

Where is Nicole Hartsough located?

Nicole Hartsough practices at 7402 E Riverside Blvd, Loves Park, IL 61111. The listed phone number is (815) 226-9642.

What is Nicole Hartsough's specialty?

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

Is Nicole Hartsough enrolled in Medicare?

Yes. Nicole Hartsough is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Hartsough was last updated on October 18, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.