Organization
SURGICAL SERVICES OF ILLINOIS, SC
Active
Other names
MD SkinCenter
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW I. JUN M.D. (PRESIDENT)
(815) 484-9900
Entity
Organization
Contact information
Practice address
1235 N MULFORD RD, STE. 205, ROCKFORD, IL 61107-3879
(815) 484-9900
(815) 487-4949
Mailing address
1235 N MULFORD RD, STE. 205, ROCKFORD, IL 61107-3879
(815) 484-9900
(815) 487-4949
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207YP0228X
Pediatric Otolaryngology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL2884
MEDICARE ID
—
Enumeration date
11/25/2009
Last updated
01/30/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us