Christopher T Kroodsma in Peoria - Dermatology
Christopher T Kroodsma - NPI 1336230051
Christopher T Kroodsma is a Dermatology in Peoria, Illinois. Christopher T Kroodsma practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Christopher T Kroodsma is 1336230051. The last update date is 2010-04-22.
Christopher T Kroodsma's current location address is 5401 N Knoxville Ave Ste 115, Peoria, Illinois. You can contact this provider via phone number 3096912903 and fax number 3096912909. The mailing address for Christopher T Kroodsma is 5401 N Knoxville Ave Ste 115, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Christopher T Kroodsma |
|---|---|
| Address | 5401 N Knoxville Ave Ste 115, Peoria, Illinois |
| Phone Number | 3096912903 |
| Fax Number | 3096912909 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1336230051 |
|---|---|
| Provider Enumeration Date | 2006-09-27 |
| Last Updated Date | 2010-04-22 |
Provider Mailing Address Detail
| Address | 5401 N Knoxville Ave Ste 115 |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616145068 |
| Phone Number | 3096912903 |
| Fax Number | 3096912909 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 3110443 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36110443 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Christopher T Kroodsma by the Centers for Medicare & Medicaid Services?
The Christopher T Kroodsma has been issued the NPI (National Provider Identifier) 1336230051 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Christopher T Kroodsma?
The Christopher T Kroodsma is situated at 5401 N Knoxville Ave Ste 115, in the city of Peoria, state of IL, with the zip code 616145068.
What is Christopher T Kroodsma's specialized field of practice, and what is the corresponding taxonomy classification code?
The Christopher T Kroodsma's area of specialization is Dermatology, and the corresponding taxonomy code that categorizes this field of practice is 207N00000X.
On what date did Christopher T Kroodsma receive its 1336230051 assignment from the Centers for Medicare & Medicaid Services?
The Christopher T Kroodsma was assigned its 1336230051 on 2006-09-27, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Christopher T Kroodsma, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Christopher T Kroodsma, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2010-04-22.
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