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Organization

PRAIRIE PATHOLOGY AND LABORATORY PHYSICIANS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YOUNG BAI KIM MD (DIRECTOR)
(309) 454-0731
Entity
Organization

Contact information

Practice address
VIRGINIA AT FRANKLIN, BROMENN REGIONAL MEDICAL CENTER, NORMAL, IL 61761
(309) 454-0731
(309) 452-2375
Mailing address
PO BOX 1808, BLOOMINGTON, IL 61702-1808
(309) 454-0731
(309) 452-2375

Taxonomy

Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
IL

Other

Enumeration date
08/10/2005
Last updated
07/21/2022
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