KIRK MOBERG (NPI# 1235153677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235153677 |
Entity Type | Individual |
Full Name | KIRK MOBERG |
Credential | MD |
Practice Address |
602 W University Avenue Administration Urbana IL 61801 |
Mailing Address |
P.o. Box 6002 Urbana IL 61803-6002 |
Practice Telephone | 2173836039 |
Mailing Telephone | 2173268300 |
Enumeration Date | 2006-07-27 |
Last Update Date | 2012-06-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
036084765 | IL | Allopathic & Osteopathic Physicians |
Street Address |
602 W UNIVERSITY AVENUE ADMINISTRATION |
City | URBANA |
State | IL |
Zip Code | 61801 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407875628 | Farah S Gaudier | Pathology | 602 W University Avenue, Pathology Lab, Urbana, IL 61801 | 2006-07-19 |
1508073578 | Nancy Mings | Social Worker | 602 W University Avenue, Pediatrics, Urbana, IL 61801 | 2007-05-17 |
1750420287 | Thomas P Malee | Optometrist | 602 W University Avenue, Ophthalmology/optometry, Urbana, IL 61801 | 2007-02-05 |
1134200611 | Richard L Meisel | Obstetrics & Gynecology | 602 W University Avenue, Urbana, IL 61801 | 2006-10-18 |
1942224134 | Donald A Greeley | Internal Medicine | 602 W University Avenue, Pulmonary Medicine, Urbana, IL 61801 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
Find all providers in zip 61801 |
Taxonomy Code | 207RA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Addiction Medicine |
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033343132 | Richard Joseph Wallyn | Internal Medicine | 1300 Brassie Ave., Flossmoor, IL 60422-1812 | 2009-05-05 |
1477752160 | Arthur Hoffman | Internal Medicine | 2652 Broadway Ave, Evanston, IL 60201 | 2007-07-13 |
1659300796 | Abhin Singla | Internal Medicine | 801 N Larkin Ave Ste 101, Joliet, IL 60435 | 2006-07-01 |
1841238979 | Mysore N Shivaram | Internal Medicine | 6901 Cermak Rd, Berwyn, IL 60402-2160 | 2006-06-02 |
1659342665 | Albert C Tanlim | Internal Medicine | 845 S 4th St, Roberts Clinic Ltd, Watseka, IL 60970-1628 | 2006-01-28 |
1184189672 | Calumet Counseling and Dui Services,inc | Internal Medicine | 1010 W 95th St, Chicago, IL 60643-1522 | 2019-02-08 |
1407395346 | Bhs Physician Services of Illinois PC | Internal Medicine | 1237 E 1600 North Rd, Gilman, IL 60938-6112 | 2017-02-13 |
1588929525 | Opioid Addiction Recovery Services PC | Internal Medicine | 755 S Milwaukee Ave, Suite 210, Libertyville, IL 60048-3253 | 2012-07-05 |
1376819565 | Sahar Eftekhar | Internal Medicine | 1 E Superior St Ste 306, Chicago, IL 60611-2595 | 2012-04-01 |
1942585468 | Ngu Md. Wellness Ltd. | Internal Medicine | 400 E Randolph St, Apt 2711, Chicago, IL 60601-7329 | 2011-10-15 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.