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Organization
IOWA DERMATOLOGY INSTITUTE, P.C.
Active
Organization
IOWA DERMATOLOGY INSTITUTE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL W. SODERSTROM M.D. (PHYSICIAN)
(309) 674-7546
Entity
Organization
Contact information
Practice address
2315 ROOSEVELT ST, CLINTON, IA 52732-2412
(563) 242-3571
(563) 243-4971
Mailing address
4909 N GLEN PARK PLACE RD, PEORIA, IL 61614-4676
(309) 674-7546
(309) 282-0500
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
NULL
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
NULL
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
NULL
207NS0135X
Procedural Dermatology Physician
—
—
208200000X
Plastic Surgery Physician
—
NULL
208200000X
Plastic Surgery Physician
—
—
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
NULL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
—
NULL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
—
—
Other
Enumeration date
06/11/2007
Last updated
09/11/2025
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