Organization
PREMIER MEDICAL GROUP, LLC
Active
Other names
Drs. Kulb, Chalian and Leak Urology
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HESSE (EXECUTIVE DIRECTOR)
(309) 662-6200
Entity
Organization
Contact information
Practice address
1401 EASTLAND DR STE B, BLOOMINGTON, IL 61701-3514
(309) 663-9424
(309) 663-6350
Mailing address
1401 EASTLAND DR STE B, BLOOMINGTON, IL 61701-3514
(309) 663-9424
(309) 663-6350
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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