SODERSTROM DERMATOLOGY CENTER S C is an ambulatory surgical clinic center in Peoria, IL. SODERSTROM DERMATOLOGY CENTER S C NPI is 1053362343. The provider is registered as an organization entity type.
The provider Is Doing Business As Peoria Ambulatory Surgery Center.
The provider's business location address is:
4909 N GLEN PARK PLACE RD
PEORIA, IL
ZIP 61614-676
Phone: (309) 690-6012
The provider's authorized official is Tina M Peugh .
The authorized official title is Executive Director, Soderstrom Derm and has the following contact phone number (309) 674-7546.
The CLIA number assigned to this NPI record is 14D2240670 - ambulatory surgery center with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 5/12/2006 and was last updated on 6/25/2008.