Legacy Dermatology PLLC
NPI 1053024554 · Dermatology Physician · Algonquin, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Legacy Dermatology PLLC is a Dermatology Physician organization in Algonquin, IL (NPI 1053024554).
Provider details
- NPI number
- 1053024554
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Laurence Bradley, Md/Owner(415) 802-1310
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-12-29
- Last updated
- 2023-05-22
- Certified
- 2023-05-22
Frequently asked questions
- What is Legacy Dermatology PLLC's NPI number?
- Legacy Dermatology PLLC's National Provider Identifier (NPI) is 1053024554, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Legacy Dermatology PLLC?
- Legacy Dermatology PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Legacy Dermatology PLLC located?
- Legacy Dermatology PLLC's practice location on file with NPPES is 2230 Huntington Dr N, Algonquin, IL 60102-4419.
- What is Legacy Dermatology PLLC's phone number?
- The practice phone number listed in the NPPES registry for Legacy Dermatology PLLC is (415) 802-1310.
- Does Legacy Dermatology PLLC accept Medicare?
- Legacy Dermatology PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Legacy Dermatology PLLC?
- The authorized official listed on Legacy Dermatology PLLC's NPPES record is Laurence Bradley, Md/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Legacy Dermatology PLLC's NPI active?
- Yes — Legacy Dermatology PLLC's NPI (1053024554) is active in the NPPES registry as of the last update on 2023-05-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.