Dawn E Soderstrom, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209011370 Issued in IL

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(630) 538-6120

NPI assigned

Mar 18, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Home Health Services, Inc.

  • Inpatient Hospice
  • Addison, IL
  • NPI 1982657292
  Medicare reassignment NPD
• Signature Medical Clinic LLC

  • Multi-Specialty Clinic/Center
  • Mount Prospect, IL
  • NPI 1558995779
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1124445952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "630-538-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "630-538-6120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1804 S Tyler Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "IL",
            "postal_code": "601744572",
            "country_code": "US",
            "telephone_number": "630-251-7267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SODERSTROM",
        "first_name": "DAWN",
        "middle_name": "E",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN (INDIVIDUAL)",
            "identifier": "P01356275",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL0",
            "identifier": "F400132098",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kishkalena Snider
• Casey J Snow
• Snyders Drug
• Michael A Sobboh
• Yelene Socarras, ARNP
• Amandeep Kaur Sohal
• Tami Soleim, LMFT
• Matia Sollom, LMFT
• Kate Lara Solomons
• Laura Marie Solyntjes, MD

• Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.