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

Northside Dermatology, SC

Organization Medical Specialty Clinic/Center · NPI 1861943888

Northside Dermatology, SC is a Medical Specialty Clinic/Center in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

1663 W Carmen Ave
Chicago, IL 60640-2701
Phone: (312) 420-7409
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence 036.132972 (IL)

Record details

NPI number1861943888
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Ida — Practice Owner · (773) 293-7500
NPI enumeratedOctober 14, 2016
Last updated in NPPESApril 20, 2020
Certification dateApril 20, 2020
Mailing address1663 W Carmen Ave, Chicago, IL 60640-2701

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