CHANG KI SONG

PEORIA, IL
NPI1609892728
Other NameC K SONG
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208600000X Surgery
(Licence: IL  036060265)
Additional Taxonomies2086S0129X Surgery, Vascular Surgery
(Licence: IL  036060265)
Enumeration Date2006-07-14
Last Update Date2008-12-05
Business Address
Dr. CHANG KI SONG MD
5401 N KNOXVILLE AVE SUITE 217
PEORIA, IL 61614-5098
Phone number: 309-691-1092
Mailing Address
Dr. CHANG KI SONG MD
5401 N KNOXVILLE AVE SUITE 209
PEORIA, IL 61614-5098
Phone number: 309-691-1092