Central Illinois Dermatology, S.C. in Peoria - Dermatology
Central Illinois Dermatology, S.C. - NPI 1548358054
Central Illinois Dermatology, S.C. is a Dermatology in Peoria, Illinois. Central Illinois Dermatology, S.C. practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Central Illinois Dermatology, S.C. is 1548358054. The last update date is 2010-07-13.
Central Illinois Dermatology, S.C.'s current location address is 5401 N Knoxville Ave, Peoria, Illinois. You can contact this provider via phone number 3096912903 and fax number 3096912909. The mailing address for Central Illinois Dermatology, S.C. is 5401 N Knoxville Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Central Illinois Dermatology, S.C. |
|---|---|
| Address | 5401 N Knoxville Ave, Peoria, Illinois |
| Phone Number | 3096912903 |
| Fax Number | 3096912909 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Kroodsma T Christopher |
| Credentials | M.D. |
| Telephone Number | 3096912903 |
NPI Number Detail
| NPI Number | 1548358054 |
|---|---|
| Provider Enumeration Date | 2006-10-10 |
| Last Updated Date | 2010-07-13 |
Provider Mailing Address Detail
| Address | 5401 N Knoxville Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616145095 |
| Phone Number | 3096912903 |
| Fax Number | 3096912909 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 42004157 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Central Illinois Dermatology, S.C. by the Centers for Medicare & Medicaid Services?
The Central Illinois Dermatology, S.C. has been issued the NPI (National Provider Identifier) 1548358054, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Central Illinois Dermatology, S.C.'s facilities are geographically located?
The facilities of Central Illinois Dermatology, S.C. are physically situated at the following location: 5401 N Knoxville Ave, Peoria, IL, 616145095.
What is Central Illinois Dermatology, S.C.'s area of expertise and its corresponding taxonomy classification?
The Central Illinois Dermatology, S.C.'s field of specialization is Dermatology, and it falls under the taxonomy code 207N00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Central Illinois Dermatology, S.C. receive its 1548358054 assignment from the Centers for Medicare & Medicaid Services?
The Central Illinois Dermatology, S.C. was assigned its 1548358054 by the Centers for Medicare & Medicaid Services on 2006-10-10.
As of what date was the information regarding Central Illinois Dermatology, S.C., such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Central Illinois Dermatology, S.C., including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2010-07-13.