Individual
MU WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W. PARK ST., PEDIATRICS, URBANA, IL 61801
(217) 383-3100
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036118219
IL
208000000X
Pediatrics Physician
47590
MN
2080P0206X
Pediatric Gastroenterology Physician
Primary
036118219
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
777630600
—
MN
01
—
IL2613
MEDICARE GROUP PTAN
IL
01
—
IL2613037
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
02/14/2006
Last updated
01/20/2026
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