Individual provider · Type 1 NPI

Kim Keith Wiese, PA-C

Physician Assistant · Peoria, IL

NPI number 1801866744 Active

Practice location

1524 W Glen Ave
Peoria, IL 61614-4692

Fax (094) 030-3973

Specialties and licenses

Taxonomy	Code	License
Physician Assistant Primary	363A00000X	085.006503 (IL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1801866744

Kim Keith Wiese, PA-C's National Provider Identifier is 1801866744, issued on Jan 24, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Peoria, IL. The record was last updated on May 19, 2020.