| 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 |