Soderstrom, Carl William

Soderstrom, Carl William is an individual health care provider with primary practice located at 4909 N Glen Park Place Rd , Peoria IL 61614-4676. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Soderstrom, Carl William can be contacted via phone (309) 674-7546.

Contact Information

Primary practice address
4909 N Glen Park Place Rd Peoria IL 61614-4676
Phone: (309) 674-7546
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X Illinois
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X Illinois

Profile Details

NPI number 1053370759
LBN Legal business name Soderstrom, Carl William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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