Chen Wang (NPI# 1174599260, PAC ID# 1254353907) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1174599260 |
| PAC ID by PECOS | 1254353907 |
| Professional Enrollment ID | I20051222000365 |
| Full Name | Chen Wang |
| Organization Legal Name | SODERSTROM DERMATOLOGY CENTER S C |
| Address |
4909 N Glen Park Place Rd Peoria IL 61614-4676 |
| Phone Number | 3096747546 |
| Gender | F |
| Credential | MD |
| Graduation Year | 1983 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 2062432651 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | M |
| Address | Phone | Organization |
|---|---|---|
| 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 | 3096747546 | SODERSTROM DERMATOLOGY CENTER S C |
| 10240 W Indian School Rd, Suite 115, Phoenix, AZ 85037-5905 | 6232439077 | REGENCY SKIN INSTITUTE PLLC |
| Organization Legal Name | SODERSTROM DERMATOLOGY CENTER S C |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nour Almardini | Pathology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| James M Jeffries Iii | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 60 S Soangetaha Rd, Galesburg, IL 61401-7524 |
| Carl W Soderstrom Jr. | Dermatology | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Stuart H Berryman | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| Carissa L Pardekooper | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Joy M Watson | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Jennifer G Tomelden | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| John E Lomax | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Michelle L Roth | Physician Assistant | Soderstrom Dermatology Center S C | 60 S Soangetaha Rd, Galesburg, IL 61401-7524 |
| Katherine E Shindelar | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Street Address |
4909 N GLEN PARK PLACE RD |
| City | PEORIA |
| State | IL |
| Zip | 61614-4676 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nour Almardini | Pathology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| John E Lomax | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Laurence M Bradley | Dermatology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Sara R Snarr | Nurse Practitioner | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| John R Soderstrom | Physician Assistant | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Joshua B Kentosh | Dermatology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kurt Michael Pepperell | Chiropractic | 3530 W Willow Knolls Dr, Peoria, IL 61614-1010 | |
| Caleb O Johnson | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3531 Willow Knolls Dr, Peoria, IL 61614-1078 |
| Lance A Reiman | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3531 Willow Knolls Dr, Peoria, IL 61614-1078 |
| Caitlin Marie Pribble | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3531 Willow Knolls Dr, Peoria, IL 61614-1078 |
| James L Swingler | Obstetrics/gynecology | 7501 N University St, Suite 113, Peoria, IL 61614-1234 | |
| Christine A Haynes | Chiropractic | Haynes Family Chiropractic Inc | 1921 W Willow Knolls Dr, Suite D, Peoria, IL 61614-1243 |
| Kyle J Haynes | Chiropractic | Haynes Family Chiropractic Inc | 1921 W Willow Knolls Dr, Suite D, Peoria, IL 61614-1243 |
| Christine Marie Fletcher | Qualified Speech Language Pathologist | Speech and Language Rehabilitation Service Ltd | 2001 W Willow Knolls Dr, Suite 106, Peoria, IL 61614-1262 |
| Danila L Mcasey | Qualified Speech Language Pathologist | Speech and Language Rehabilitation Service Ltd | 2001 W Willow Knolls Dr, Suite 106, Peoria, IL 61614-1262 |
| Keith A Kramer | Chiropractic | Kramer Chiropractic and Acupuncture | 2208 W Willow Knolls Rd, Peoria, IL 61614-1467 |
| Find all physicians in zip 61614 | |||
| City | PEORIA |
| Zip Code | 61614 |
| Specialty | PATHOLOGY |
| City + Specialty | PEORIA + PATHOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.