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Organization

PINNACLE DERMATOLOGY, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSE L RIOS MD (VICE-PRESIDENT)
(630) 388-9033
Entity
Organization

Contact information

Practice address
1124 ESSINGTON RD, JOLIET, IL 60435-8423
(815) 744-8554
(815) 744-3969
Mailing address
PO BOX 734241, CHICAGO, IL 60673-4241
(815) 744-8554
(815) 744-3969

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
208200000X
Plastic Surgery Physician
036109103
IL
332900000X
Non-Pharmacy Dispensing Site
332B00000X
Durable Medical Equipment & Medical Supplies
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
02/09/2017
Last updated
02/02/2026
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