Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Central Illinois Dermatology, SC

Organization Dermatology Physician · NPI 1548358054

Central Illinois Dermatology, SC is a Dermatology Physician in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006

Practice location Address checks out

5401 N Knoxville Ave Ste 115
Peoria, IL 61614-5095
Phone: (309) 691-2903
Fax: (309) 691-2909
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 042004157 (IL)

Record details

NPI number1548358054
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christopher Kroodsma — President · (309) 691-2903
NPI enumeratedOctober 10, 2006
Last updated in NPPESJuly 13, 2010
Mailing address5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5095

Other providers in Peoria