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Individual

DR. XIAO-TIAN AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1300 FRANKLIN AVE, NORMAL, IL 61761-3592
(309) 454-1400
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.123730
IL
2085R0202X
Diagnostic Radiology Physician
PENDING
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036.123730
STATE LICENSE
IL
05
036123730
IL
Enumeration date
03/27/2006
Last updated
02/16/2024
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