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

Soderstrom Dermatology Center S C

Organization Dermatology Physician · NPI 1710931670

Soderstrom Dermatology Center S C is a Dermatology Physician in Peoria, Illinois. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
7

Practice location Address checks out

4909 N Glen Park Place Rd
Peoria, IL 61614-4676
Phone: (309) 674-7546
Show map & directions

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

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Dermatopathology Physician Taxonomy 207ND0900X
Procedural Dermatology Physician Taxonomy 207NS0135X
Dermatopathology (Pathology) Physician Taxonomy 207ZD0900X
Plastic Surgery Physician Taxonomy 208200000X
Surgery Physician Taxonomy 208600000X

Record details

NPI number1710931670
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Christina Peugh — Executive Director · (309) 674-7546
NPI enumeratedMay 22, 2006
Last updated in NPPESApril 8, 2008
Mailing address4909 N Glen Park Place Rd, Peoria, IL 61614-4676

Other providers in Peoria