Individual
WONIL TAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 SAINT ANTHONYS WAY, ALTON, IL 62002-4569
(618) 642-2222
Mailing address
2 SAINT ANTHONYS WAY, ALTON, IL 62002-4569
(618) 642-2222
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036121542
IL
207R00000X
Internal Medicine Physician
30927
AL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036121542
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511-15246
BCBS AL
AL
Enumeration date
06/26/2008
Last updated
04/23/2025
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