| Dr Tesfu Hailu, MD | |
|
4909 N Glen Park Place Rd, Peoria, IL 61614-4676 | |
| (309) 674-7546 | |
| (309) 691-9286 |
| Full Name | Dr Tesfu Hailu |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 31 Years |
| Location | 4909 N Glen Park Place Rd, Peoria, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245490382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ND0900X | Dermatology - Dermatopathology | 036151973 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Soderstrom Dermatology Center S C. | 2062432651 | 33 |
| Soderstrom Dermatology Center S C. | 2062432651 | 33 |
| Entity Name | Soderstrom Dermatology Center S C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710931670 PECOS PAC ID: 2062432651 Enrollment ID: O20051128000693 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tesfu Hailu, MD 4909 N Glen Park Place Rd, Peoria, IL 61614-4689 Ph: (309) 674-7546 | Dr Tesfu Hailu, MD 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 Ph: (309) 674-7546 |
Taylor Marie Wells, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 4909 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-712-4193 | |
Dr. Carl William Soderstrom Jr., M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 4909 N Glen Park Place Rd, Peoria, IL 61614 Phone: 309-674-7546 | |
Dr. Janeen Noelle Buonaccorsi, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637 Phone: 309-624-9052 | |
Christopher T Kroodsma, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614 Phone: 309-691-2903 Fax: 309-691-2909 | |
Ashley Steffens, Dermatology Medicare: May Accept Medicare Assignments Practice Location: 5401 N Knoxville Ave, Peoria, IL 61614 Phone: 093-691-2903 Fax: 309-691-2909 | |
Harry C Stone, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 5401 N Knoxville Ave, Suite 115, Peoria, IL 61614 Phone: 309-691-2903 |