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

Soderstrom Dermatology Center S C

Organization Ambulatory Surgical Clinic/Center · NPI 1053362343

Soderstrom Dermatology Center S C is an Ambulatory Surgical Clinic/Center 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

4909 N Glen Park Place Rd
Peoria, IL 61614-4676
Phone: (309) 690-6012
Show map & directions

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

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 7001530 (IL)

Record details

NPI number1053362343
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSoderstrom Dermatology Center S C
Authorized official Tina Peugh — Executive Director, Soderstrom Derm · (309) 674-7546
Other names Peoria Ambulatory Surgery Center
NPI enumeratedMay 12, 2006
Last updated in NPPESJune 25, 2008
Mailing address4909 N Glen Park Place Rd, Peoria, IL 61614-4676

Other providers in Peoria