CENTRAL ILLINOIS DERMATOLOGY, S.C.

PEORIA, IL
NPI1548358054
Entity TypeOrganization
Authorized ContactCHRISTOPHER T KROODSMA
President
309-691-2903
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
(Licence: IL  042004157)
Enumeration Date2006-10-10
Last Update Date2010-07-13
Business Address
CENTRAL ILLINOIS DERMATOLOGY, S.C.
5401 N KNOXVILLE AVE SUITE 115
PEORIA, IL 61614-5095
Phone number: 309-691-2903
Mailing Address
CENTRAL ILLINOIS DERMATOLOGY, S.C.
5401 N KNOXVILLE AVE SUITE 115
PEORIA, IL 61614-5095
Phone number: 309-691-2903