MD SKINCENTER
NPI 1932437290
Dermatology in Rockford, IL
NPI Status: Active since November 25, 2009
Contact Information
1235 N MULFORD RD
STE. 205
ROCKFORD, IL
ZIP 61107
Phone: (815) 484-9900
Fax: (815) 487-4949
- Organization
- Dermatology
- Accepts Insurance
- CLIA Number: 14D1074608
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-30-2025
About MD SKINCENTER
This page provides the complete NPI Profile along with additional information for Md Skincenter, a provider established in Rockford, Illinois operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1932437290 assigned on November 2009. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Md Skincenter operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Md Skincenter. The authorized official of this NPI record is Dr. Andrew I. Jun M.d. (President)
- NPI
- 1932437290
- Provider Legal Name
- SURGICAL SERVICES OF ILLINOIS, SC
- Other Organization Name
- MD SKINCENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1235 N MULFORD RD STE. 205 ROCKFORD, IL 61107
- Location Phone
- (815) 484-9900
- Location Fax
- (815) 487-4949
- Mailing Address
- 1235 N MULFORD RD STE. 205 ROCKFORD, IL 61107
- Mailing Phone
- (815) 484-9900
- Mailing Fax
- (815) 487-4949
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-25-2009
- Last Update Date
- 01-30-2023
- Code Navigator
A dermatologist like Md Skincenter is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | |
| 2 | 207NP0225X | Allopathic & Osteopathic Physicians | Dermatology | |
| 3 | 207NS0135X | Allopathic & Osteopathic Physicians | Dermatology | |
| 4 | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 5 | 207YP0228X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 6 | 207YS0123X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 7 | 207YX0007X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 8 | 207YX0602X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 9 | 207YX0905X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 10 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | |
| 11 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) $9100 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| IL2884 | OTHER (01) | MEDICARE ID |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1074608
- Facility Type
- Physician Office
- Certificate Effective Date
- April 18, 2022
- Certificate Expiration Date
- June 30, 2025
- Laboratory Director
- ANDREW I. JUN
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Md Skincenter after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 3 | 2 | 4 | 3 | 7 | 2 | 9 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 6 | 2 | 8 | 3 | 14 | 2 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 6 + 2 + 8 + 3 + 1 + 4 + 2 + 1 + 8 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1932437290 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1326048547 | CHRISTOPHER A GREEN MD Individual | Orthopaedic Surgery | 1235 N MULFORD RD ROCKFORD, IL 61107 (815) 398-7755 |
| 1497755573 | SCOTT JONES PT Individual | Physical Medicine & Rehabilitation | 1235 N MULFORD RD ROCKFORD, IL 61107 (920) 451-8142 |
| 1295722650 | DAVID L MCCARTY MD Individual | Orthopaedic Surgery | 1235 N MULFORD RD STE 100 ROCKFORD, IL 61107 (815) 484-9999 |
| 1740277102 | ORTHOPEDIC ASSOCIATES OF NORTHERN ILLINOIS, LLC Organization | Orthopaedic Surgery | 1235 N MULFORD RD SUITE 100 ROCKFORD, IL 61107 (815) 484-9999 |
| 1508812611 | ORTHOPAEDIC & ARTHRITIS CLINIC OF ROCKFORD LTD Organization | Orthopaedic Surgery | 1235 N MULFORD RD ROCKFORD, IL 61107 (815) 398-7755 |
| 1083621627 | DONALD H HOLDER MD Individual | Orthopaedic Surgery | 1235 N MULFORD RD ROCKFORD, IL 61107 (815) 637-8637 |
| 1346449022 | ADVANCED ALLERGY & ENT, LLC Organization | Otolaryngology | 1235 N MULFORD RD SUITE 100 ROCKFORD, IL 61107 (815) 484-9900 |
| 1922295328 | ADVANCED FACIAL PLASTICS & MOHS Organization | Dermatology (MOHS-Micrographic Surgery) | 1235 N MULFORD RD SUITE 100 ROCKFORD, IL 61107 (815) 484-9900 |
| 1881877686 | VIVEK THAPPA, M.D., S.C. Organization | Internal Medicine (Pulmonary Disease) | 1235 N MULFORD RD SUITE 100 ROCKFORD, IL 61107 (815) 316-1899 |
| 1669640504 | TODD D ALEXANDER MD SC Organization | Neurological Surgery | 1235 N MULFORD RD SUITE 210 ROCKFORD, IL 61107 (815) 397-0077 |
| 1306211198 | MRS. CHRISTINE LENOX LCPC Individual | Counselor (Professional) | 1235 N MULFORD RD SUITE 200 ROCKFORD, IL 61107 (815) 965-6644 |
| 1447276480 | MEDICAL PAIN MANAGEMENT SERVICES, LTD. Organization | Clinic/Center (Pain) | 1235 N MULFORD RD ROCKFORD, IL 61107 (815) 397-8400 |
| 1962873919 | RENVIVA LLC Organization | Clinic/Center (End-Stage Renal Disease (ESRD) Treatment) | 1235 N MULFORD RD ROCKFORD, IL 61107 (513) 673-5245 |
| 1578971487 | NORTHERN ILLINOIS TRAUMA REGIONAL ORTHOPAEDICS, LLC Organization | Orthopaedic Surgery (Orthopaedic Trauma) | 1235 N MULFORD RD SUITE 103 ROCKFORD, IL 61107 (815) 636-0700 |
| 1821091075 | DR. SUSAN M FOWELL MD Individual | Ophthalmology (Retina Specialist) | 1235 N MULFORD RD SUITE 100 ROCKFORD, IL 61107 (815) 226-4990 |
| 1942483664 | NORTHERN ILLINOIS RETINA LTD Organization | Ophthalmology (Retina Specialist) | 1235 N MULFORD RD SUITE 100 ROCKFORD, IL 61107 (815) 226-4990 |
| 1609952670 | MS. VIRGINIA L. VELAZQUEZ NP Individual | Nurse Practitioner | 1235 N MULFORD RD SUITE 222 ROCKFORD, IL 61107 (815) 397-8400 |
| 1154576221 | MS. TANYA J. MUNGER NP Individual | Nurse Practitioner | 1235 N MULFORD RD SUITE 222 ROCKFORD, IL 61107 (815) 397-8400 |
| 1245381458 | EMPICARE, INC. Organization | Durable Medical Equipment & Medical Supplies | 1235 N MULFORD RD SUITE 100A ROCKFORD, IL 61107 (815) 226-5600 |
| 1508979345 | JACK W LENOX M.D. Individual | Obstetrics & Gynecology (Gynecology) | 1235 N MULFORD RD STE 200 ROCKFORD, IL 61107 (815) 965-6644 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1932437290, enumerated in the NPI registry as an "organization" on November 25, 2009
The provider is located at 1235 N Mulford Rd Ste. 205 Rockford, Il 61107 and the phone number is (815) 484-9900
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois, Quartz,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 14D1074608 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on November 25, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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