Jae K Kim, MD | |
210 W Walnut St, Canton, IL 61520-2444 | |
(309) 647-5240 | |
(309) 647-5104 |
Full Name | Jae K Kim |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 210 W Walnut St, Canton, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316981491 | NPI | - | NPPES |
036056328 | Medicaid | IL | |
P00945642 | Other | IL | RAILROAD MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 036056328 (Illinois) | Primary |
Mailing Address | Practice Location Address |
---|---|
Jae K Kim, MD 7309 N Knoxville Ave, Suite 200, Peoria, IL 61614-2085 Ph: (309) 691-6225 | Jae K Kim, MD 210 W Walnut St, Canton, IL 61520-2444 Ph: (309) 647-5240 |
Keith Harvey Ifft, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 210 W Walnut St, Canton, IL 61520 Phone: 309-360-2600 | |
Dr. Glen N Feather, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 180 S Main St, Canton, IL 61520 Phone: 309-647-0201 Fax: 309-649-6880 |