Central Illinois Dermatology, S.C.

LBN: Central Illinois Dermatology, S.C.
Central Illinois Dermatology, S.C. is an health care organization with primary practice located at 5401 N Knoxville Ave Suite 115, Peoria IL 61614-5095. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Central Illinois Dermatology, S.C. can be contacted via phone (309) 691-2903, or through Kroodsma, Christopher T via phone (309) 691-2903.

Contact Information

Primary practice address
5401 N Knoxville Ave Suite 115 Peoria IL 61614-5095
Phone: (309) 691-2903
Fax: (309) 691-2909
Website:
Map and Directions
Authorized official contact:
Name: Kroodsma, Christopher T Doctor of Medicine (MD)
Phone: (309) 691-2903

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 042004157 Illinois

Profile Details

NPI number 1548358054
LBN Legal business name Central Illinois Dermatology, S.C.
DBA Doing business as
Authorized official Kroodsma, Christopher T Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2006
Last updated Jul 13th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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