Organization
PRAIRIE DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLYN STOEWER PA (PHYSICIAN ASSISTANT)
(309) 531-1252
Entity
Organization
Contact information
Practice address
1015 S MERCER AVE STE GF7, BLOOMINGTON, IL 61701-7107
(309) 660-8442
Mailing address
1015 S MERCER AVE STE GF7, BLOOMINGTON, IL 61701-7107
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
03/09/2026
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