Individual
MICHAELIA VASILIA FOSSES VUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
701 N 1ST ST STE D220, SPRINGFIELD, IL 62702-3757
(217) 545-3518
Mailing address
PO BOX 19679, SPRINGFIELD, IL 62794-9679
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125069974
IL
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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