Individual
KEVIN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-1200
Mailing address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-1200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2019021744
MO
207R00000X
Internal Medicine Physician
2022004128
MO
207R00000X
Internal Medicine Physician
5101027375
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036175383
IL
208000000X
Pediatrics Physician
2019021744
MO
Other
Enumeration date
03/26/2019
Last updated
08/05/2025
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