Healthcare Provider Details

I. General information

NPI: 1811821697
Provider Name (Legal Business Name): PINNACLE DERMATOLOGY, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SPRINGER DR
LOMBARD IL
60148-6413
US

IV. Provider business mailing address

PO BOX 734240
CHICAGO IL
60673-4240
US

V. Phone/Fax

Practice location:
  • Phone: 815-744-8554
  • Fax:
Mailing address:
  • Phone: 629-240-8670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMIE L HOPKINS
Title or Position: SR. DIRECTOR, CREDENTIALING AND RCM
Credential:
Phone: 276-252-0773