Individual
KEVIN REGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FRANKLIN AVE, NORMAL, IL 61761-3558
(309) 268-5130
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036154193
IL
207P00000X
Emergency Medicine Physician
125070584
IL
Other
Enumeration date
03/04/2015
Last updated
10/27/2021
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