Organization
DERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY K MCKENNA (PHYSICIAN OWNER)
(309) 451-3376
Entity
Organization
Contact information
Practice address
303 N HERSHEY RD STE B, BLOOMINGTON, IL 61704-7720
(309) 451-3376
(309) 452-3376
Mailing address
302 INNOVATION DR STE 400, FRANKLIN, TN 37067-2022
(615) 224-7755
(615) 716-3787
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036.129240
IL
Other
Enumeration date
12/04/2012
Last updated
07/09/2026
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