Individual
TERESA S KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1285
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1285
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036141894
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036141894
IL
2085R0202X
Diagnostic Radiology Physician
625
SC
Other
Enumeration date
07/06/2006
Last updated
07/26/2022
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