Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Legacy Dermatology PLLC

Organization Dermatology Physician · NPI 1053024554

Legacy Dermatology PLLC is a Dermatology Physician in Algonquin, Illinois. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2230 Huntington Dr N
Algonquin, IL 60102-4419
Phone: (415) 802-1310
Fax: (847) 960-3675
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1053024554
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Laurence Bradley — Md/Owner · (415) 802-1310
NPI enumeratedDecember 29, 2022
Last updated in NPPESMay 22, 2023
Certification dateMay 22, 2023
Mailing address2230 Huntington Dr N, Algonquin, IL 60102-4419

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