NPI 1336230051

Christopher T Kroodsma, MD

Practitioner Dermatology Physician Peoria, IL

Practice location

Address: 5401 N Knoxville Ave Suite 115, Peoria, IL 61614-5098
Phone: (309) 691-2903
Fax: (309) 691-2909
Mailing address: 5401 N Knoxville Ave STE 115, Peoria, IL 61614-5068

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 03110443 (IL)

Other Dermatology providers in Illinois →

Registry record

NPI: 1336230051
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Sep 2006
Record last updated: 22 Apr 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.