Kirk Moberg
Internist - Addiction Medicine
602 W University Avenue Administration
Urbana
, Illinois 61801
Kirk Moberg
Internist - Addiction Medicine
602 W University Avenue Administration
Urbana
, Illinois 61801
(217) 326-8300
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About
Features
Specialties
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Kirk Moberg
- P.o. Box 6002
- Urbana, IL
- Zip : 61803-6002
- Phone : (217) 326-8300
Second Address
- Kirk Moberg
- 602 W University Avenue Administration
- Urbana, IL
- Zip : 61801
- Phone : (217) 383-6039
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0401X | Internist - Addiction Medicine | 036084765 | IL |
National Provider Identifier
| NPI | 1235153677 |
|---|---|
| Provider Name | Kirk Moberg |
| First Address | Urbana, IL 61803-6002 |
| Second Address | Urbana, IL 61801 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/07/2006 |
| Last Update Date | 12/06/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| F11054 | (02) | |
| F11054 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.