Active NPI 1396711503 Individual Practitioner Male Practitioner

Dr. Manuel S Mesirow , MD

Specialist • Tinley Park, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Manuel Mesirow, MD is a certified Specialist practicing in Tinley Park, IL. With approximately 50 years of clinical experience since graduating from University Of Michigan Medical School in 1976, Dr. Mesirow delivers high-quality medical care to the local community at 18425 W WEST CREEK DR.

Dr. Mesirow is affiliated with Dermatology Associates Ltd and 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

18425 W West Creek Dr
Ste F

Tinley Park, IL 604776767

Telephone 7084448300

Fax 7084448301

Associated Practice Facility / Clinic

🏢 North Creek Dental Pc Facility NPI 1700800356

Medicare Profile & Education

Medical School

University Of Michigan Medical School

Graduation Year

1976

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Tinley Park, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

50 Yrs Matches City Avg

City Avg: 50.0 Yrs

State Avg: 38.5 Yrs

Regional Practice Density

13 Specialists

Practicing in Tinley Park, IL (1322 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

51.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mesirow (50 Years) 50 Yrs

Tinley Park Specialty Average (50.0 Years) 50.0 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	999	169	$15.00	$6.77
99213 Established patient office or other outpatient visit, typically 15 minutes	454	378	$175.00	$93.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	352	248	$248.00	$131.67
17000 Destruction of skin growth	307	243	$132.00	$50.86
17110 Destruction of up to 14 skin growths	252	208	$223.00	$105.89
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	134	32	$15.00	$0.91
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	97	40	$40.00	$14.40
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	96	80	$35.00	$16.80
11900 Injection into skin growth, 1-7 growths	89	63	$111.00	$50.64
11102 Tangential biopsy of single skin lesion	77	72	$203.00	$80.19
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	62	57	$233.00	$111.08
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	56	56	$220.00	$116.32
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	46	43	$244.00	$113.39
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	43	43	$337.00	$170.92
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	36	35	$212.00	$82.64
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	32	27	$275.00	$123.76
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	27	23	$350.00	$181.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	24	$110.00	$58.46
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	21	19	$279.00	$134.78
17004 Destruction of precancer skin growth, 15 or more growths	19	16	$323.00	$173.58
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	19	17	$290.00	$149.83
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	19	15	$245.00	$102.81
99202 New patient office or other outpatient visit, typically 20 minutes	16	16	$156.00	$74.63
11104 Punch biopsy, first skin growth	14	12	$255.00	$128.93
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	13	13	$283.00	$137.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,039	172	$15.00	$7.04
99213 Established patient office or other outpatient visit, typically 15 minutes	586	440	$175.00	$95.17
17000 Destruction of skin growth	303	237	$132.00	$54.40
17110 Destruction of up to 14 skin growths	234	202	$223.00	$109.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	150	119	$248.00	$133.32
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	104	31	$15.00	$1.03
11900 Injection into skin growth, 1-7 growths	91	56	$111.00	$53.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	88	88	$220.00	$119.53
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	58	52	$233.00	$110.26
11102 Tangential biopsy of single skin lesion	48	47	$203.00	$87.36
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	41	29	$40.00	$14.50
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	39	37	$244.00	$115.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	39	$110.00	$59.81
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	34	31	$212.00	$79.84
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	32	30	$275.00	$142.45
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	24	23	$279.00	$138.00
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	22	20	$245.00	$117.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$337.00	$176.67
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	20	16	$290.00	$142.35
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	15	$350.00	$186.17
99202 New patient office or other outpatient visit, typically 20 minutes	15	15	$156.00	$76.58
17004 Destruction of precancer skin growth, 15 or more growths	14	12	$323.00	$181.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,069	171	$15.00	$7.27
99213 Established patient office or other outpatient visit, typically 15 minutes	698	467	$175.00	$96.68
17000 Destruction of skin growth	280	217	$131.67	$53.46
17110 Destruction of up to 14 skin growths	251	208	$222.94	$112.38
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	111	26	$15.00	$1.13
11900 Injection into skin growth, 1-7 growths	103	60	$110.94	$51.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	86	86	$220.00	$120.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	81	75	$248.00	$133.46
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	68	62	$232.97	$118.18
11102 Tangential biopsy of single skin lesion	60	57	$203.00	$89.55
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	43	29	$40.00	$15.29
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	41	39	$244.00	$124.57
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	38	36	$211.95	$89.83
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	37	31	$275.00	$134.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	36	35	$109.83	$60.72
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	25	24	$279.00	$136.59
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	23	20	$245.00	$123.06
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	23	18	$349.91	$193.83
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	18	15	$290.00	$133.40
J1100 Injection, dexamethasone sodium phosphate, 1 mg	18	15	$15.00	$0.12
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$337.00	$178.40
17004 Destruction of precancer skin growth, 15 or more growths	16	14	$323.00	$182.74
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$156.00	$78.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,318	191	$14.97	$7.04
99213 Established patient office or other outpatient visit, typically 15 minutes	613	432	$174.93	$97.99
17000 Destruction of skin growth	328	244	$127.99	$53.06
17110 Destruction of up to 14 skin growths	208	173	$221.98	$114.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	146	122	$247.82	$138.19
11900 Injection into skin growth, 1-7 growths	91	66	$109.93	$51.79
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	68	22	$15.00	$1.27
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	62	55	$233.00	$110.61
11102 Tangential biopsy of single skin lesion	61	58	$203.00	$85.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	44	44	$219.91	$121.28
17004 Destruction of precancer skin growth, 15 or more growths	34	26	$323.00	$181.21
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	33	29	$275.00	$135.64
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	29	26	$244.00	$122.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	28	$108.00	$60.47
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	29	26	$290.00	$151.56
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	27	22	$40.00	$15.18
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	24	22	$245.00	$117.50
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	24	23	$211.00	$103.73
J1100 Injection, dexamethasone sodium phosphate, 1 mg	16	13	$15.00	$0.14
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	11	11	$348.00	$195.32
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	11	11	$283.00	$151.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	971	160	$24.52	$6.35
99213 Established patient office or other outpatient visit, typically 15 minutes	468	384	$128.68	$79.74
17000 Destruction of skin growth	232	207	$120.27	$52.75
17110 Destruction of up to 14 skin growths	138	132	$194.17	$113.53
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	100	23	$15.00	$1.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	69	69	$75.47	$48.75
11102 Tangential biopsy of single skin lesion	63	61	$168.91	$93.02
99202 New patient office or other outpatient visit, typically 20 minutes	49	49	$134.74	$81.33
11900 Injection into skin growth, 1-7 growths	42	36	$95.77	$51.55
17004 Destruction of precancer skin growth, 15 or more growths	27	24	$307.36	$169.95
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	27	26	$192.70	$113.50
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	26	20	$37.13	$15.08
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	24	23	$197.61	$117.19
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	12	11	$246.51	$135.94
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	12	11	$216.56	$132.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,231	337	$50.00	$6.06
99213 Established patient office or other outpatient visit, typically 15 minutes	1,224	829	$130.00	$77.91
17000 Destruction of skin growth	569	444	$140.00	$53.07
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	384	82	$15.00	$1.54
17110 Destruction of up to 14 skin growths	380	313	$186.46	$109.54
99202 New patient office or other outpatient visit, typically 20 minutes	312	312	$135.00	$80.41
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	287	249	$75.00	$47.63
11102 Tangential biopsy of single skin lesion	204	191	$150.12	$89.29
11900 Injection into skin growth, 1-7 growths	151	105	$90.00	$51.76
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	127	82	$40.00	$17.22
17004 Destruction of precancer skin growth, 15 or more growths	66	47	$406.00	$161.35
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	65	61	$185.00	$113.23
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	56	53	$200.00	$119.67
87101 Fungal culture (mold or yeast) of skin, hair, or nail	45	42	$24.00	$8.02
J1100 Injection, dexamethasone sodium phosphate, 1 mg	39	34	$15.00	$0.12
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	37	34	$260.00	$147.72
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	33	31	$160.00	$91.07
99201 New patient office or other outpatient visit, typically 10 minutes	27	27	$75.00	$48.85
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	26	25	$240.00	$129.56
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	25	25	$250.00	$145.05
87220 Tissue fungi or parasites	24	22	$17.00	$4.65
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	18	$290.00	$190.57
11104 Punch biopsy, first skin growth	18	17	$190.00	$133.32
11103 Biopsy of related skin growth, each additional growth	17	16	$90.00	$57.21
11200 Removal of skin tag, 1-15 skin tags	16	16	$170.00	$71.43
10040 Acne surgery	15	12	$165.00	$105.74
11901 Injection into skin growth, more than 7 growths	15	13	$120.00	$69.37
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	14	14	$200.00	$121.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,354	345	$50.00	$5.67
99213 Established patient office or other outpatient visit, typically 15 minutes	1,354	889	$129.79	$76.12
17000 Destruction of skin growth	602	450	$140.00	$55.25
99202 New patient office or other outpatient visit, typically 20 minutes	447	447	$131.50	$78.66
11100 Biopsy of single growth of skin and/or tissue	430	382	$190.00	$98.33
17110 Destruction of up to 14 skin growths	406	347	$185.00	$113.96
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	370	322	$75.00	$46.28
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	333	75	$15.00	$1.77
11900 Injection into skin growth, 1-7 growths	155	115	$90.00	$51.57
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	129	99	$40.00	$21.45
17004 Destruction of precancer skin growth, 15 or more growths	65	51	$406.00	$153.21
87101 Fungal culture (mold or yeast) of skin, hair, or nail	64	58	$24.00	$9.04
J1100 Injection, dexamethasone sodium phosphate, 1 mg	58	52	$15.00	$0.12
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	45	40	$260.00	$139.40
87220 Tissue fungi or parasites	38	34	$17.00	$5.04
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	30	28	$290.00	$188.30
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	25	25	$250.00	$142.44
11901 Injection into skin growth, more than 7 growths	24	18	$120.00	$69.48
99201 New patient office or other outpatient visit, typically 10 minutes	23	23	$75.00	$47.36
11101 Biopsy of each additional growth of skin and/or tissue	22	18	$85.00	$35.14
11200 Removal of skin tag, 1-15 skin tags	17	16	$170.00	$60.35
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	16	15	$240.00	$116.08
17260 Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less	13	13	$169.00	$78.90
10040 Acne surgery	11	11	$165.00	$96.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,510	366	$50.00	$6.05
99213 Established patient office or other outpatient visit, typically 15 minutes	1,551	956	$125.00	$76.49
17000 Destruction of skin growth	668	504	$140.00	$55.91
99202 New patient office or other outpatient visit, typically 20 minutes	535	535	$128.00	$78.16
17110 Destruction of up to 14 skin growths	450	361	$185.00	$114.18
11100 Biopsy of single growth of skin and/or tissue	414	381	$190.00	$96.74
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	406	331	$75.00	$45.56
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	390	91	$15.00	$1.80
11900 Injection into skin growth, 1-7 growths	188	136	$90.00	$50.64
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	162	109	$40.00	$26.77
17004 Destruction of precancer skin growth, 15 or more growths	95	74	$406.00	$160.54
J1100 Injection, dexamethasone sodium phosphate, 1 mg	81	63	$15.00	$0.12
87101 Fungal culture (mold or yeast) of skin, hair, or nail	66	61	$24.00	$10.36
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	54	48	$260.00	$141.36
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	38	32	$290.00	$181.79
11200 Removal of skin tag, 1-15 skin tags	34	32	$170.00	$70.88
87220 Tissue fungi or parasites	32	30	$17.00	$5.74
11101 Biopsy of each additional growth of skin and/or tissue	31	26	$85.00	$34.04
69100 Biopsy of ear	29	28	$160.00	$87.07
11901 Injection into skin growth, more than 7 growths	23	17	$120.00	$70.23
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	23	23	$243.04	$151.45
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	22	22	$236.36	$118.64
99201 New patient office or other outpatient visit, typically 10 minutes	15	15	$75.00	$46.52
17260 Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less	15	13	$169.00	$67.95
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	14	14	$192.50	$110.00
17271 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	13	11	$268.00	$157.29

Medical Specialties & State Licenses

CMS Verified: 2021-12-07

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License IL 036054932

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Hospital & Practice Group Affiliations

Dermatology Associates Ltd

18425 W Creek Dr, Tinley Park, IL 604776768

Phone: 7084448300

Practice Associates & Co-Workers

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

5 Associated Practitioners

Dr. Vivek Iyengar , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1073589297

Doctor of Medicine (M.D.)

Dr. Tia Pyle , MD

Dermatology

NPI 1336528835

Doctor of Medicine (M.D.)

Dr. Arnold Gombiner , MD

Specialist

NPI 1629044847

Doctor of Medicine (M.D.)

Michelle Ovando , PA-C

Physician Assistant - Medical

NPI 1760676969

Physician Assistant (Certified)

Catrina Brucato , PA-C

Physician Assistant - Medical

NPI 1912216458

Physician Assistant (Certified)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active August 28, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location August 28, 2007

Registered at 18425 W WEST CREEK DR, STE F, TINLEY PARK, IL 604776767 (Tel: 7084448300)

📍

Updated Business Mailing Address August 28, 2007

Registered at 18425 W WEST CREEK DR, STE F, TINLEY PARK, IL 604776767 (Tel: 7084448300)

👤

Provider Name / Credentials Updated August 28, 2007

Recorded as MANUEL MESIROW, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2007

Specialist (License #036054932 in IL)

🟢

Initial NPI Registration & Enumeration February 27, 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: 1396711503

Entity Type:

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

Enumeration Date: February 27, 2006

Last Update: December 07, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

18425 W West Creek Dr, Ste F

Tinley Park, IL 604776767

Phone: 7084448300

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.