Active NPI 1457354334 Individual Practitioner Male Practitioner

Dr. Bruce Kolton , MD

Dermatology • Hoffman Estates, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Bruce Kolton, MD is a certified Dermatology practicing in Hoffman Estates, IL. With approximately 54 years of clinical experience since completing medical education in 1972, Dr. Kolton delivers high-quality medical care to the local community at 2500 W HIGGINS RD.

Dr. Kolton accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2500 W Higgins Rd
Ste 940

Hoffman Estates, IL 601952085

Telephone 8478399999

Fax 8478851111

Associated Practice Facility / Clinic

🏢 Alan D Johnson Md Ltd Facility NPI 1851381966

Medicare Profile & Education

Medical School

Other

Graduation Year

1972

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Hoffman Estates, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

54 Yrs +23.7 yrs vs City Avg

City Avg: 30.3 Yrs

State Avg: 23.1 Yrs

Regional Practice Density

9 Specialists

Practicing in Hoffman Estates, IL (673 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

48.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kolton (54 Years) 54 Yrs

Hoffman Estates Specialty Average (30.3 Years) 30.3 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
17003 Destruction of precancer skin growth, 2-14 growths	453	48	$23.00	$6.24
99213 Established patient office or other outpatient visit, typically 15 minutes	423	269	$155.28	$88.12
17000 Destruction of skin growth	94	67	$130.00	$58.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	80	80	$195.00	$109.83
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	46	32	$190.00	$91.14
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	32	20	$280.00	$166.13
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	27	19	$180.00	$58.88
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	27	22	$190.00	$97.49
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	25	19	$350.00	$190.71
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	21	$101.00	$54.47
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	21	16	$171.43	$76.77
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	20	17	$240.00	$121.91
17004 Destruction of precancer skin growth, 15 or more growths	18	13	$300.00	$161.45
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	11	$300.00	$177.16
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	14	13	$290.00	$148.96
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	12	12	$240.00	$136.26
11104 Punch biopsy, first skin growth	11	11	$225.00	$108.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	480	295	$154.60	$93.85
17003 Destruction of precancer skin growth, 2-14 growths	458	58	$60.68	$6.85
17000 Destruction of skin growth	105	79	$130.00	$63.08
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	87	87	$194.83	$119.02
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	43	32	$190.00	$86.90
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	38	31	$175.26	$68.79
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	36	29	$240.00	$111.39
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	34	25	$190.00	$110.76
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	31	20	$280.00	$173.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	18	$225.00	$133.71
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	21	$100.73	$57.69
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	20	13	$350.00	$206.93
17004 Destruction of precancer skin growth, 15 or more growths	19	14	$300.00	$179.07
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	19	13	$240.00	$144.50
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	14	$300.00	$188.96
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	18	14	$160.00	$78.78
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	17	13	$240.00	$105.36
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	13	$230.00	$127.27
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	13	12	$160.00	$81.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	521	308	$144.99	$96.52
17003 Destruction of precancer skin growth, 2-14 growths	372	54	$23.00	$7.11
17000 Destruction of skin growth	99	75	$137.27	$58.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	80	80	$190.00	$120.86
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	50	43	$173.72	$99.42
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	38	23	$283.68	$156.84
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	38	28	$167.63	$88.18
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	36	30	$185.50	$118.08
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	35	24	$174.86	$74.28
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	34	31	$240.00	$132.28
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	29	24	$353.62	$213.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	29	24	$215.00	$135.45
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	29	25	$286.55	$163.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	20	$79.24	$60.59
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	23	18	$185.87	$98.50
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	20	$244.13	$153.84
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	20	14	$300.00	$173.10
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	16	$198.32	$124.43
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	16	13	$151.88	$69.12
11104 Punch biopsy, first skin growth	16	11	$176.88	$132.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$275.00	$179.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	594	338	$134.45	$97.56
17003 Destruction of precancer skin growth, 2-14 growths	514	68	$23.00	$6.88
17000 Destruction of skin growth	131	94	$140.00	$61.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	105	105	$181.24	$119.17
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	63	53	$223.17	$127.31
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	53	47	$168.00	$95.44
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	45	32	$170.00	$87.31
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	42	33	$192.76	$116.25
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	37	31	$160.00	$71.53
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	33	26	$355.00	$216.90
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	32	24	$290.00	$177.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	30	26	$78.00	$60.02
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	27	22	$150.00	$77.77
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	25	21	$290.00	$174.77
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	18	$196.00	$138.29
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	20	$176.19	$138.80
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	21	20	$245.00	$157.21
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$240.50	$181.05
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	16	$300.00	$193.51
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	19	12	$220.00	$105.80
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	18	15	$185.00	$94.14
17004 Destruction of precancer skin growth, 15 or more growths	17	14	$422.00	$178.85
11104 Punch biopsy, first skin growth	13	13	$175.00	$124.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	595	339	$130.00	$79.98
17003 Destruction of precancer skin growth, 2-14 growths	489	64	$23.00	$6.30
17000 Destruction of skin growth	120	89	$140.00	$60.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$180.00	$115.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	55	44	$78.00	$48.69
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	55	43	$168.00	$89.82
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	51	39	$220.00	$119.83
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	39	26	$340.00	$209.75
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	38	24	$290.00	$168.11
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	32	26	$160.00	$62.02
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	27	20	$167.04	$89.90
17004 Destruction of precancer skin growth, 15 or more growths	20	18	$422.00	$169.03
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	17	14	$196.00	$127.49
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	16	12	$177.50	$90.91
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	16	14	$245.00	$133.52
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	15	12	$150.00	$86.77
11104 Punch biopsy, first skin growth	14	11	$175.00	$130.05
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	14	12	$290.00	$157.86
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	13	12	$184.00	$108.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	791	418	$130.00	$78.44
17003 Destruction of precancer skin growth, 2-14 growths	523	71	$23.00	$6.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	145	100	$78.00	$47.67
17000 Destruction of skin growth	144	110	$140.00	$62.39
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	135	135	$180.00	$116.13
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	92	60	$168.00	$83.33
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	68	52	$220.00	$116.66
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	51	36	$340.00	$212.75
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	49	32	$286.33	$171.67
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	47	32	$160.00	$62.25
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	46	39	$160.00	$91.74
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	34	25	$184.00	$109.96
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	26	23	$290.00	$179.97
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	26	22	$170.00	$102.79
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	24	22	$241.67	$143.46
17004 Destruction of precancer skin growth, 15 or more growths	24	18	$422.00	$164.29
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	21	17	$150.00	$67.36
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	20	18	$196.00	$131.81
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	11	$300.00	$184.71
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	14	$220.00	$114.69
11104 Punch biopsy, first skin growth	14	13	$173.71	$123.53
11200 Removal of skin tag, 1-15 skin tags	11	11	$150.00	$73.68

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	813	431	$130.00	$72.27
17003 Destruction of precancer skin growth, 2-14 growths	651	88	$23.00	$5.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	171	171	$180.00	$108.56
17000 Destruction of skin growth	169	117	$140.00	$58.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	121	97	$78.00	$43.52
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	76	54	$168.00	$90.82
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	69	47	$160.00	$63.38
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	68	55	$219.12	$116.82
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	53	40	$160.00	$82.42
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	40	30	$184.00	$75.23
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	33	26	$280.00	$165.13
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	31	25	$340.00	$198.01
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	29	21	$220.00	$118.55
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	28	24	$150.00	$67.19
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	26	21	$235.00	$134.60
11100 Biopsy of single growth of skin and/or tissue	25	24	$166.00	$89.31
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	21	17	$170.00	$99.40
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	19	17	$196.00	$134.72
17004 Destruction of precancer skin growth, 15 or more growths	18	12	$422.00	$146.43
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	18	11	$300.00	$163.79
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	16	16	$290.00	$176.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	880	459	$130.00	$72.07
17003 Destruction of precancer skin growth, 2-14 growths	642	98	$23.00	$5.68
17000 Destruction of skin growth	191	138	$140.00	$58.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	153	153	$180.00	$107.11
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	118	92	$78.00	$43.08
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	90	66	$167.58	$88.92
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	71	56	$190.14	$120.96
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	49	40	$160.00	$90.55
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	48	34	$160.00	$56.68
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	39	29	$280.00	$155.44
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	38	27	$337.89	$192.74
17004 Destruction of precancer skin growth, 15 or more growths	28	21	$422.00	$150.76
11100 Biopsy of single growth of skin and/or tissue	27	27	$166.00	$99.35
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	27	25	$184.00	$72.54
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	27	23	$170.00	$95.07
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	26	24	$290.00	$165.88
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	25	18	$150.00	$60.58
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	20	19	$235.00	$131.26
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	17	15	$220.00	$109.73
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	15	$196.00	$121.43
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	12	$300.00	$180.62

Medical Specialties & State Licenses

CMS Verified: 2026-06-09

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License IL 036047580

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

Medicaid State Provider ID

0360475801 (IL)

Practice Associates & Co-Workers

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

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Pediatrics

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Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active January 05, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location January 05, 2012

Registered at 2500 W HIGGINS RD, STE 940, HOFFMAN ESTATES, IL 601952085 (Tel: 8478399999)

📍

Updated Business Mailing Address January 05, 2012

Registered at 160 GREENBRIAR DR, DEERFIELD, IL 600155024 (Tel: 8479450773)

👤

Provider Name / Credentials Updated January 05, 2012

Recorded as BRUCE KOLTON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2012

Dermatology (License #036047580 in IL)

🟢

Initial NPI Registration & Enumeration May 24, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1457354334

Entity Type:

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

Enumeration Date: May 24, 2005

Last Update: June 09, 2026

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

160 Greenbriar Dr

Deerfield, IL 600155024

Phone: 8479450773

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

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