Healthcare Provider Details

I. General information

NPI: 1003730888
Provider Name (Legal Business Name): DERMATOLOGY STUDIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2272 95TH ST STE 225
NAPERVILLE IL
60564-8965
US

IV. Provider business mailing address

2272 95TH ST STE 225
NAPERVILLE IL
60564-8965
US

V. Phone/Fax

Practice location:
  • Phone: 630-379-7198
  • Fax:
Mailing address:
  • Phone: 630-379-7198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHAKI D PATEL
Title or Position: OWNER
Credential: MD
Phone: 630-379-7198