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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD.
NPI 1770828626
Specialist in Bloomington, IL

Active since December 04, 2012CLIA 14D2054063 · Certificate of Compliance
303 N HERSHEY RD STE B, BLOOMINGTON, IL 61704(309) 451-3376(309) 452-3376 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dermatology And Mohs Surgery Institute, Ltd. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD. (NPI 1770828626) is a healthcare organization registered as a specialist in Bloomington, Illinois and active in the NPI registry since December 2012. The organization holds a CLIA Certificate of Compliance certificate valid through October 10, 2027 and lists Jeffrey K Mckenna, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1770828626
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameDERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD.
Location Address303 N HERSHEY RD STE BBloomington, IL 61704-7720
Mailing Address302 Innovation Dr Ste 400Franklin, TN 37067-2022 · (615) 224-7755 · Fax (615) 716-3787
Phone(309) 451-3376
Fax(309) 452-3376
Organization SubpartNo
Authorized OfficialJeffrey K MckennaPhysician Owner · (309) 451-3376
Enumeration DateDecember 4, 2012
Last NPPES UpdateJuly 9, 2026
NPPES CertifiedJuly 9, 2026
✔ NPI 1770828626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in IL · 036.129240
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
303 N HERSHEY RD STE B, Bloomington, IL 61704
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 14D2054063

Dermatology & Mohs Surgery Institute · Bloomington, IL
Active · expires Oct 10, 2027
CLIA Number14D2054063
Laboratory TypePhysician Office
Certificate Effective DateOctober 11, 2025
Certificate Expiration DateOctober 10, 2027
Laboratory DirectorJeffery Mckenna
Laboratory Phone(309) 451-3376
Laboratory LocationDermatology & Mohs Surgery Institute303 N Hershey Rd, Bloomington, IL 61704
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRANCHING OFF, INC
Home Health
303 N HERSHEY RD STE B
BLOOMINGTON, IL 61704
McLean County (309) 808-4409

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dermatology And Mohs Surgery Institute, Ltd.'s NPI number?

The NPI number for Dermatology And Mohs Surgery Institute, Ltd. is 1770828626. It was assigned to this organization in the NPPES registry on December 4, 2012.

Where is Dermatology And Mohs Surgery Institute, Ltd. located?

Dermatology And Mohs Surgery Institute, Ltd. is located at 303 N Hershey Rd Ste B, Bloomington, IL 61704. The listed phone number is (309) 451-3376.

What is Dermatology And Mohs Surgery Institute, Ltd.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Dermatology And Mohs Surgery Institute, Ltd. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 14D2054063) is associated with this NPI, valid through October 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermatology And Mohs Surgery Institute, Ltd. was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.