Individual
MR. JUNO SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3311
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3440
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
—
—
363L00000X
Nurse Practitioner
Primary
209021590
IL
Other
Enumeration date
10/02/2009
Last updated
03/31/2021
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