| Mathew Joseph, | |
| 2160 S 1st Ave, Maywood, IL 60153-3328 | |
| (708) 216-9000 | |
| Not Available | 
| Full Name | Mathew Joseph | 
|---|---|
| Gender | Male | 
| Speciality | Dermatology | 
| Location | 2160 S 1st Ave, Maywood, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1245729433 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207N00000X | Dermatology | 01088687A (Indiana) | Primary | 
| 207N00000X | Dermatology | 036164482 (Illinois) | Secondary | 
| Entity Name | Dermio Dermatology Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1811402423 PECOS PAC ID: 7315206687 Enrollment ID: O20180111002019 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mathew Joseph, 9200 Calumet Ave # 203, Munster, IN 46321-2885 Ph: () - | Mathew Joseph, 2160 S 1st Ave, Maywood, IL 60153-3328 Ph: (708) 216-9000 | 
| Zisansha Zahirsha,  Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-4533 Fax: 708-216-5446 | |
| Lauren Moy, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
| James Swan, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, (321 Lagrange Rd., Lagrande Park, Il.60526), Maywood, IL 60153 Phone: 708-485-1020 Fax: 708-485-1173 | |
| Rachit Gupta, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
| Dr. Jenna Janiga Lullo, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
| Dr. Farinoosh Dadrass, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-4962 |