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Individual
KIM TREVIRANUS
Active
Individual
KIM TREVIRANUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
036061910
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061910
—
IL
01
—
091400
HEALTH ALLIANCE MEDICAL
IL
01
—
9815737
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/16/2006
Last updated
11/13/2018
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