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

Prairie Dermatology, PLLC

Organization Dermatology Physician · NPI 1881333680

Prairie Dermatology, PLLC is a Dermatology Physician in Bloomington, Illinois. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1015 S Mercer Ave Ste GF7
Bloomington, IL 61701-7107
Phone: (309) 660-8442
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1881333680
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Caitlyn Stoewer — Physician Assistant · (309) 531-1252
NPI enumeratedMay 31, 2022
Last updated in NPPESMarch 9, 2026
Certification dateMarch 9, 2026
Mailing address1015 S Mercer Ave Ste Gf7, Bloomington, IL 61701-7107

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