Christopher T Kroodsma, MD | |
5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5098 | |
(309) 691-2903 | |
(309) 691-2909 |
Full Name | Christopher T Kroodsma |
---|---|
Gender | Male |
Speciality | Dermatology |
Experience | 25 Years |
Location | 5401 N Knoxville Ave, Peoria, Illinois |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336230051 | NPI | - | NPPES |
036110443 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 03110443 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Central Illinois Dermatology Sc | 2860463510 | 5 |
Entity Name | Central Illinois Dermatology Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548358054 PECOS PAC ID: 2860463510 Enrollment ID: O20040804001797 |
Mailing Address | Practice Location Address |
---|---|
Christopher T Kroodsma, MD 5401 N Knoxville Ave Ste 115, Peoria, IL 61614-5068 Ph: (309) 691-2903 | Christopher T Kroodsma, MD 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614-5098 Ph: (309) 691-2903 |
Dr. Carl William Soderstrom Jr., M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4909 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-674-7546 | |
Dr. Janeen Noelle Buonaccorsi, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-9052 | |
Dr. Tesfu Hailu, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4909 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-674-7546 Fax: 309-691-9286 | |
Ashley Steffens, Dermatology Medicare: May Accept Medicare Assignments Practice Location: 5401 N Knoxville Ave, Peoria, IL 61614 Phone: 093-691-2903 Fax: 309-691-2909 | |
Harry C Stone, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614 Phone: 309-691-2903 | |
Jamie Lynn Frey, MD Dermatology Medicare: May Accept Medicare Assignments Practice Location: 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614 Phone: 309-691-2903 Fax: 309-691-2909 |