Peoria Ambulatory Surgery Center

LBN: Soderstrom Dermatology Center S C
Peoria Ambulatory Surgery Center is an health care organization with primary practice located at 4909 N Glen Park Place Rd , Peoria IL 61614-4676. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Soderstrom Dermatology Center S C can be contacted via phone (309) 690-6012, or through Peugh, Tina M via phone (309) 674-7546.

Contact Information

Primary practice address
4909 N Glen Park Place Rd Peoria IL 61614-4676
Phone: (309) 690-6012
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Peugh, Tina M MBA
Phone: (309) 674-7546

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 7001530 Illinois

Profile Details

NPI number 1053362343
LBN Legal business name Soderstrom Dermatology Center S C
DBA Doing business as Peoria Ambulatory Surgery Center
Authorized official Peugh, Tina M MBA
Entity Organization
Organization subpart 1 Yes
Enumeration date May 12th, 2006
Last updated Jun 25th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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