Provider Demographics
NPI:1194225268
Name:UNITED SKIN SPECIALISTS ILLINOIS LTD, PC
Entity type:Organization
Organization Name:UNITED SKIN SPECIALISTS ILLINOIS LTD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHWEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-283-3000
Mailing Address - Street 1:33 E 33RD ST FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5362
Mailing Address - Country:US
Mailing Address - Phone:212-283-3000
Mailing Address - Fax:
Practice Address - Street 1:4107 S WATER TOWER PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6293
Practice Address - Country:US
Practice Address - Phone:618-244-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SDG MGMT COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-15
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty