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Soderstrom Dermatology Center S C
Ambulatory Surgical Clinic/Center in Peoria, Illinois
NPI 1053362343

Soderstrom Dermatology Center S C is an Ambulatory Surgical Clinic/Center based in Peoria, IL and is specialized in Ambulatory Surgical. Soderstrom Dermatology Center S C practices in Peoria, IL. The NPI Number for Soderstrom Dermatology Center S C is 1053362343 and holds a License No. 7001530 (Illinois).

The current practice location address for Soderstrom Dermatology Center S C is 4909 N Glen Park Place Rd, Peoria, IL and can be reached out via phone at 309-690-6012.

Location: 4909 N Glen Park Place Rd, Peoria, IL, 61614-4676
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1053362343
Provider Name
Soderstrom Dermatology Center S C
Credential
Provider Entity Type
Organization
Address
4909 N Glen Park Place Rd, Peoria, IL, 61614-4676
Phone Number
309-690-6012
Fax Number
Provider Enumeration Date
05/12/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
4909 N Glen Park Place Rd
City
Peoria
State
Illinois
Zip
61614-4676
Phone Number
309-690-6012
Fax Number
person
Provider Business Mailing Address Details
Address
4909 N Glen Park Place Rd
City
Peoria
State
Illinois
Zip
61614-4676
Phone Number
309-690-6012
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
261QA1903X
License No.
7001530 (Illinois)
Definition
Definition to come...
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