Individual
KIRK MOBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
602 W UNIVERSITY AVENUE, ADMINISTRATION, URBANA, IL 61801
(217) 383-6039
Mailing address
P.O. BOX 6002, URBANA, IL 61803-6002
(217) 326-8300
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
036084765
IL
Other
Enumeration date
07/27/2006
Last updated
06/12/2012
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