Most Relevant Information
Provider Data
| NPI Number: | 1003478942 |
| Provider Name: | MINWOO KIM CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 209019559 |
Most Important Dates
| Enumeration Date: | 07/01/2019 |
| Last Updated: | 07/01/2019 |
Provider Practice Location
611 W PARK ST
URBANA
IL
618012529
Practice Location Phone/Fax
| Phone: | 2173833303 |
| Fax: | 2173833265 |
Provider Mailing Location
611 W PARK ST
URBANA
IL
618012529
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |