Soderstrom Dermatology Center S C in Peoria, IL

This location of Soderstrom Dermatology Center S C bills under NPI 1710931670, an organization record issued on May 22, 2006 with the primary taxonomy Dermatology Physician. It is one of 2 NPIs registered under this name and one of 2 in Peoria; each clinician who sees you there has their own NPI and license.

CMS NPPES registry, file of Aug 9, 2026 · method · Verify with CMS →

Organization recordNPPES, Aug 2026

1710931670

Legal name: Soderstrom Dermatology Center S C
Entity: Type 2 · organization
Primary taxonomy: Dermatology Physician 207N00000X
Practice location: 4909 N GLEN PARK PLACE RD, Peoria, IL 61614
Phone: 309-674-7546
Enumerated: May 22, 2006
Record updated: Apr 8, 2008
Authorized official: Executive Director (title as filed)

Public record from the NPPES NPI Registry (open it on CMS). An NPI identifies who bills; it is not a facility license.

The other Peoria NPI

Soderstrom Dermatology Center S C4909 N GLEN PARK PLACE RD · issued May 12, 20061053362343

11 clinicians CMS lists with Soderstrom Dermatology Center S C in Peoria

Ista Egbeto, MDDermatology Physician1962080754
Khaled El-Hoshy, MDDermatology Physician1831163377
Todd Gerlach, MDPlastic Surgery Physician1518046044
Michael Hayes, DODermatology Physician1912017245
Chad HoerrPhysician Assistant1689495152
Renata Jenkin, MDDermatology Physician1700848462
Jordyn Lewandowski, APRNFamily Nurse Practitioner1144892175
Karen Maloney, MDDermatology Physician1912918186
John Soderstrom, PAPhysician Assistant1871506931
Allison WangDermatology Physician1063953354
Taylor Wells, MDDermatology Physician1013596998

Source: CMS Doctors and Clinicians group affiliations, matched by practice name and city.

All 2 Soderstrom Dermatology Center S C NPIs

Every location registered under this name, in 1 city.

See every location

Checking an organization

Confirm the business with the Illinois secretary of state.
Check the HHS-OIG exclusion list for the organization.
Verify each clinician on their own record and the state license search.

All taxonomies on this record

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

Common questions

Is an organization NPI a license?

No. An NPI identifies who bills. Facilities and the clinicians who work there are licensed separately by the state.

Which Peoria NPI should I use?

Ask the office which NPI it bills under; all 2 Peoria NPIs are registered under the same name.

Source: CMS National Plan and Provider Enumeration System (NPPES), monthly file of Aug 9, 2026 (NPPES files on CMS.gov). An NPI identifies who bills; it is not a license.