Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Chang Ki Song, MD

Individual provider Surgery Physician · NPI 1609892728

Dr. Chang Ki Song, MD is a Surgery Physician in Peoria, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5401 N Knoxville Ave Ste 217
Peoria, IL 61614-5098
Phone: (309) 691-1092
Fax: (309) 689-6092
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036060265 (IL)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 036060265 (IL)

Record details

NPI number1609892728
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 14, 2006
Last updated in NPPESDecember 5, 2008

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