OrganizationActive
Legacy Dermatology PLLC
NPI 1053024554 · Dermatology Physician · Algonquin, IL
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
Established profile(59/100 index)
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
2230 Huntington Dr N
Algonquin, IL 60102-4419
Phone: (415) 802-1310
Fax: (847) 960-3675
Approximate (ZIP-level) locationGet directions
Mailing address
2230 Huntington Dr N
Algonquin, IL 60102-4419
Registry dates
- Enumerated
- 2022-12-29
- Last updated
- 2023-05-22
- Certified
- 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.