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

Dr. Joshua Bradley Kentosh, DO

Individual provider MOHS-Micrographic Surgery Physician · NPI 1902096928

Dr. Joshua Bradley Kentosh, DO is a Dermatology in Peoria, Illinois. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2007, 19 years ago. Practices with Soderstrom Dermatology Center S C, a 33-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
19
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
IL
In the registry since
2007
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

4909 N Glen Park Pl
Peoria, IL 61614-4676
Phone: (309) 674-7546
Fax: (309) 691-9286
Show map & directions

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

Additional practice locations (1)

  • 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 — (309) 674-7546

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 036.142442 (IL)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence 036.142442 (IL)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence 036.142442 (IL)

Record details

NPI number1902096928
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedJuly 26, 2007
Last updated in NPPESJuly 12, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2007 (19 years in practice)
Group practice Soderstrom Dermatology Center S C — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare