Active NPI 1720025562 Individual Practitioner Male Practitioner

Dr. Ted G Van Acker , DO

Dermatology • Herrin, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Ted Van Acker, DO is a certified Dermatology practicing in Herrin, IL. With approximately 34 years of clinical experience since graduating from Michigan State University College Of Osteopathic Medicine in 1992, Dr. Van Acker delivers high-quality medical care to the local community at 220 N PARK AVE.

Dr. Van Acker is affiliated with Southern Illinois Dermatology, Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include pathology examination of tissue using a microscope, intermediate complexity, ultrasonic guidance for placement of radiation therapy fields, obtaining data needed to develop the optimal radiation treatment, 1 treatment area. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

220 N Park Ave
Suite 2

Herrin, IL 629483150

Telephone 6189423344

Fax 6189425045

Associated Practice Facility / Clinic

🏢 Southern Illinois Dermatology, Pc Facility NPI 1306870233

Medicare Profile & Education

Medical School

Michigan State University College Of Osteopathic Medicine

Graduation Year

1992

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Herrin, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

34 Yrs +0.5 yrs vs City Avg

City Avg: 33.5 Yrs

State Avg: 23.1 Yrs

Regional Practice Density

2 Specialists

Practicing in Herrin, IL (673 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

47.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Van Acker (34 Years) 34 Yrs

Herrin Specialty Average (33.5 Years) 33.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	4,822	2,258	$120.00	$32.03
G6001 Ultrasonic guidance for placement of radiation therapy fields	2,750	124	$385.00	$161.94
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	2,629	123	$605.00	$242.03
77401 Radiation treatment delivery, superficial	2,539	123	$95.00	$37.15
99213 Established patient office or other outpatient visit, typically 15 minutes	670	183	$145.42	$86.38
77336 Continuing radiation therapy consultation per week	376	103	$200.00	$80.13
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	193	166	$1850.00	$1035.02
77334 Design and construction of complex radiation treatment device	173	114	$300.00	$116.65
77300 Calculation of radiation therapy dose	172	115	$150.00	$61.43
Q4271 Complete ft, per square centimeter	171	11	$1800.00	$1638.49
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	97	92	$1646.00	$880.69
77261 Simple radiation therapy planning	87	86	$175.00	$67.92
88304 Pathology examination of tissue using a microscope, moderately low complexity	84	69	$70.00	$28.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	82	69	$200.00	$121.03
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	67	65	$1485.00	$828.95
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	46	34	$400.00	$208.22
11105 Punch biopsy, each additional skin growth	26	11	$105.00	$55.20
77262 Intermediate radiation therapy planning	20	19	$255.00	$104.19
11104 Punch biopsy, first skin growth	20	18	$215.00	$110.01
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	20	20	$2089.00	$948.69
77285 Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas	19	18	$1000.00	$398.93
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	18	18	$1530.00	$731.76
77290 Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved	16	14	$1110.00	$406.54
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	15	11	$200.00	$99.14
77263 Complex radiation therapy planning	15	14	$385.00	$162.58
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	13	13	$505.00	$240.41
17000 Destruction of skin growth	12	11	$135.00	$57.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	4,528	2,342	$120.04	$31.80
G6001 Ultrasonic guidance for placement of radiation therapy fields	1,922	101	$385.00	$165.98
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	1,811	98	$605.00	$248.14
77401 Radiation treatment delivery, superficial	1,758	97	$95.00	$37.53
Q4234 Xcellerate, per square centimeter	332	12	$1000.00	$810.42
77427 Radiation treatment management, 5 treatments	328	96	$425.00	$186.14
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	255	207	$1850.00	$1041.50
77336 Continuing radiation therapy consultation per week	224	83	$200.00	$79.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	116	$200.00	$122.72
88304 Pathology examination of tissue using a microscope, moderately low complexity	115	101	$70.00	$28.38
99213 Established patient office or other outpatient visit, typically 15 minutes	91	86	$145.00	$86.55
77300 Calculation of radiation therapy dose	86	80	$150.00	$62.35
77334 Design and construction of complex radiation treatment device	83	79	$300.00	$117.42
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	70	68	$1646.00	$874.46
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	66	51	$400.00	$213.71
77261 Simple radiation therapy planning	53	53	$175.00	$68.90
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less	29	12	$200.00	$123.06
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	27	27	$1485.00	$807.64
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	27	27	$1530.00	$727.71
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	20	20	$2089.00	$954.57
77262 Intermediate radiation therapy planning	18	18	$255.00	$105.39
77285 Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas	18	18	$1000.00	$405.66
11104 Punch biopsy, first skin growth	18	16	$215.00	$118.68
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	16	16	$505.00	$189.41
11626 Removal of malignant growth (over 4.0 centimeters) of the scalp, neck, hands, feet, or genitals	13	12	$709.00	$393.49
14040 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less	12	11	$1300.00	$729.73
17000 Destruction of skin growth	12	12	$135.00	$55.70
11644 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm	12	12	$692.00	$355.19
77290 Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved	12	11	$1110.00	$417.61
77263 Complex radiation therapy planning	12	11	$385.00	$165.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	3,964	2,186	$120.04	$31.34
G6001 Ultrasonic guidance for placement of radiation therapy fields	2,944	147	$345.95	$166.33
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	2,788	141	$604.39	$249.63
77401 Radiation treatment delivery, superficial	2,701	140	$92.90	$37.91
77427 Radiation treatment management, 5 treatments	527	139	$425.00	$186.11
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	341	275	$1850.00	$1054.76
77336 Continuing radiation therapy consultation per week	251	115	$200.00	$76.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	228	195	$200.00	$124.01
77300 Calculation of radiation therapy dose	136	127	$150.00	$61.45
99213 Established patient office or other outpatient visit, typically 15 minutes	136	128	$145.00	$87.46
77334 Design and construction of complex radiation treatment device	134	127	$300.00	$116.95
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	131	96	$400.00	$215.03
88304 Pathology examination of tissue using a microscope, moderately low complexity	106	89	$70.00	$27.95
17003 Destruction of precancer skin growth, 2-14 growths	96	23	$23.00	$6.37
77261 Simple radiation therapy planning	88	85	$175.00	$69.70
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	77	76	$1646.00	$884.34
11105 Punch biopsy, each additional skin growth	62	25	$105.00	$57.27
11104 Punch biopsy, first skin growth	44	41	$214.77	$120.48
17000 Destruction of skin growth	34	31	$135.00	$51.40
77285 Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas	30	28	$996.67	$404.81
77262 Intermediate radiation therapy planning	30	28	$255.00	$102.98
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	29	28	$1530.00	$741.41
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	27	26	$1485.00	$811.52
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	24	23	$2089.00	$958.11
77263 Complex radiation therapy planning	17	16	$385.00	$165.42
77290 Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved	17	16	$1110.00	$429.13
17110 Destruction of up to 14 skin growths	11	11	$190.00	$93.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	4,055	2,098	$120.01	$31.13
G6001 Ultrasonic guidance for placement of radiation therapy fields	1,728	91	$246.86	$145.99
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	1,639	89	$595.00	$268.67
77401 Radiation treatment delivery, superficial	1,584	88	$60.00	$40.48
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	296	246	$1850.00	$1072.30
77427 Radiation treatment management, 5 treatments	291	87	$425.00	$189.07
77336 Continuing radiation therapy consultation per week	233	78	$200.00	$76.53
17003 Destruction of precancer skin growth, 2-14 growths	228	35	$23.00	$6.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	190	149	$200.00	$126.78
11105 Punch biopsy, each additional skin growth	160	40	$105.00	$59.24
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	138	85	$400.00	$220.50
99213 Established patient office or other outpatient visit, typically 15 minutes	136	112	$143.46	$89.55
96900 Application of ultraviolet light to skin	115	11	$35.00	$21.87
88304 Pathology examination of tissue using a microscope, moderately low complexity	102	93	$70.00	$28.51
77334 Design and construction of complex radiation treatment device	83	79	$300.00	$121.66
77300 Calculation of radiation therapy dose	81	77	$150.00	$64.06
11104 Punch biopsy, first skin growth	73	62	$210.00	$121.59
17000 Destruction of skin growth	57	45	$135.00	$49.57
77261 Simple radiation therapy planning	55	54	$175.00	$70.84
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	40	38	$1646.00	$869.47
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	32	29	$2089.00	$977.53
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	30	13	$500.00	$388.67
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	24	13	$10.00	$1.25
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	23	13	$200.00	$136.31
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	22	22	$1530.00	$755.80
11900 Injection into skin growth, 1-7 growths	17	11	$95.00	$45.23
77263 Complex radiation therapy planning	16	15	$383.75	$167.80
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	16	16	$1485.00	$851.46
77290 Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved	16	15	$1110.00	$466.05
17110 Destruction of up to 14 skin growths	15	13	$190.00	$98.47
77262 Intermediate radiation therapy planning	12	12	$255.00	$107.77
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	12	12	$505.00	$200.43
77285 Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas	12	12	$975.00	$444.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	3,219	1,764	$120.03	$29.61
G6001 Ultrasonic guidance for placement of radiation therapy fields	1,301	72	$168.77	$111.92
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	1,274	73	$595.00	$262.97
77401 Radiation treatment delivery, superficial	1,227	73	$60.00	$22.99
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	310	275	$1850.00	$1080.57
99213 Established patient office or other outpatient visit, typically 15 minutes	238	143	$110.00	$73.82
77427 Radiation treatment management, 5 treatments	235	68	$423.55	$193.24
17003 Destruction of precancer skin growth, 2-14 growths	189	27	$23.00	$5.78
77336 Continuing radiation therapy consultation per week	176	69	$200.00	$75.23
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	149	91	$400.00	$223.90
11105 Punch biopsy, each additional skin growth	140	36	$105.00	$58.81
88304 Pathology examination of tissue using a microscope, moderately low complexity	114	94	$70.00	$27.45
96900 Application of ultraviolet light to skin	99	11	$35.00	$21.07
77300 Calculation of radiation therapy dose	65	63	$150.00	$64.54
77334 Design and construction of complex radiation treatment device	65	63	$300.00	$123.84
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	60	59	$1646.00	$904.95
11104 Punch biopsy, first skin growth	54	50	$210.00	$117.34
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	51	51	$2089.00	$990.32
17000 Destruction of skin growth	48	37	$135.00	$50.70
77261 Simple radiation therapy planning	47	46	$175.00	$72.64
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	32	32	$1530.00	$745.45
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	25	25	$1485.00	$854.18
17110 Destruction of up to 14 skin growths	16	16	$190.00	$87.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	3,915	2,101	$120.10	$27.87
G6001 Ultrasonic guidance for placement of radiation therapy fields	1,552	74	$115.00	$77.91
77280 Obtaining data needed to develop the optimal radiation treatment, 1 treatment area	1,398	73	$595.00	$257.94
77401 Radiation treatment delivery, superficial	1,349	73	$60.00	$22.92
99213 Established patient office or other outpatient visit, typically 15 minutes	346	147	$110.00	$71.24
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	272	230	$1850.00	$1061.56
77336 Continuing radiation therapy consultation per week	214	70	$200.00	$74.27
17003 Destruction of precancer skin growth, 2-14 growths	208	35	$23.00	$5.44
11105 Punch biopsy, each additional skin growth	173	51	$103.18	$58.06
77427 Radiation treatment management, 5 treatments	143	67	$415.00	$187.15
88304 Pathology examination of tissue using a microscope, moderately low complexity	134	111	$70.00	$26.35
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	123	82	$400.00	$224.00
96900 Application of ultraviolet light to skin	94	16	$35.00	$20.03
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	91	85	$1646.00	$913.81
11104 Punch biopsy, first skin growth	70	64	$210.00	$116.60
77300 Calculation of radiation therapy dose	70	70	$150.00	$63.78
77334 Design and construction of complex radiation treatment device	70	70	$300.00	$122.55
17000 Destruction of skin growth	60	48	$135.00	$50.33
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	51	50	$1530.00	$761.23
77261 Simple radiation therapy planning	49	49	$175.00	$70.86
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	42	42	$2089.00	$988.51
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	34	31	$1485.00	$851.77
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	22	11	$500.00	$388.53
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	16	11	$200.00	$114.16
17110 Destruction of up to 14 skin growths	15	13	$190.00	$97.97
77262 Intermediate radiation therapy planning	14	14	$255.00	$106.90
77285 Obtaining data needed to develop the optimal radiation treatment, 2 treatment areas	14	14	$975.00	$426.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	11	$70.00	$43.24
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	11	11	$510.00	$145.60
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	11	11	$588.00	$311.49
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$463.00	$264.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	3,752	2,019	$119.92	$27.50
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	290	234	$1850.00	$1051.17
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	178	108	$400.00	$223.98
96900 Application of ultraviolet light to skin	130	12	$35.00	$19.32
88304 Pathology examination of tissue using a microscope, moderately low complexity	103	90	$70.00	$26.63
17003 Destruction of precancer skin growth, 2-14 growths	96	18	$23.00	$5.13
99213 Established patient office or other outpatient visit, typically 15 minutes	86	57	$100.00	$70.67
11101 Biopsy of each additional growth of skin and/or tissue	73	25	$66.19	$32.04
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	55	54	$2089.00	$992.07
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	48	45	$1646.00	$922.37
11100 Biopsy of single growth of skin and/or tissue	46	39	$175.00	$94.52
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	32	32	$1530.00	$760.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	27	24	$60.00	$41.06
17000 Destruction of skin growth	24	21	$135.00	$49.35
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	13	13	$1482.85	$850.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
88305 Pathology examination of tissue using a microscope, intermediate complexity	3,849	2,082	$120.10	$27.04
14301 Repair of wound by transferring skin, 30.1-60.0 sq cm	249	213	$1850.00	$1045.35
14302 Repair of wound by transferring skin, each additional 30.0 sq cm	126	85	$400.00	$225.30
17003 Destruction of precancer skin growth, 2-14 growths	114	18	$23.00	$5.40
88304 Pathology examination of tissue using a microscope, moderately low complexity	100	89	$70.00	$26.63
99213 Established patient office or other outpatient visit, typically 15 minutes	90	65	$100.00	$70.33
11101 Biopsy of each additional growth of skin and/or tissue	58	25	$62.75	$31.93
14041 Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm	52	52	$1646.00	$919.35
11100 Biopsy of single growth of skin and/or tissue	49	41	$175.00	$88.29
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	47	47	$2089.00	$988.20
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	40	40	$1530.00	$756.00
17000 Destruction of skin growth	29	26	$135.00	$44.00
14021 Tissue transfer repair of wound (10.1 to 30.0 sq centimeters) of the scalp, arms, and/or legs	24	24	$1471.00	$847.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	24	$60.00	$41.66
11643 Removal of malignant growth (2.1 to 3.0 centimeters) of the face, ears, eyelids, nose, or lips	19	19	$588.00	$310.26
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	17	13	$505.00	$221.63
17110 Destruction of up to 14 skin growths	17	15	$190.00	$101.52
11646 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, more than 4.0 cm	13	13	$893.00	$503.96
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	12	12	$463.00	$250.84
11644 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 3.1-4.0 cm	11	11	$692.00	$383.01

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Railroad Medicare Grp #

CB3700 (IL)

Commercial Insurance / Payer ID Healthlink Prov Number

290730 (IL)

Commercial Insurance / Payer ID Bcbs Group Number

10007459 (IL)

Commercial Insurance / Payer ID Umwa Provider Number

L84853 (IL)

Hospital & Practice Group Affiliations

Southern Illinois Dermatology, Pc

220 N Park Ave, Herrin, IL 629483150

Phone: 6189423344

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Leon Gauthier , PA-C

Physician Assistant

NPI 1033145172

Physician Assistant (Certified)

Dr. Derek Kenneaster , MD

Dermatology

NPI 1457372724

Doctor of Medicine (M.D.)

Joshua Loyd , FNP-BC

Nurse Practitioner - Family

NPI 1598445405

Family Nurse Practitioner (Board Certified)

Shanda Swagler , FNP-C

Nurse Practitioner - Family

NPI 1750526810

Family Nurse Practitioner (Certified)

Natalie Spiller , PA-C

Physician Assistant

NPI 1942550272

Physician Assistant (Certified)

Gerri Dyer , NP

Nurse Practitioner

NPI 1952328486

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 220 N PARK AVE, SUITE 2, HERRIN, IL 629483150 (Tel: 6189423344)

📍

Updated Business Mailing Address July 08, 2007

Registered at 220 N PARK AVE, SUITE 2, HERRIN, IL 629483150 (Tel: 6189423344)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as TED VAN ACKER, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dermatology

🟢

Initial NPI Registration & Enumeration June 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720025562

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 01, 2006

Last Update: July 08, 2007

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

220 N Park Ave, Suite 2

Herrin, IL 629483150

Phone: 6189423344

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.