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

Song Kang, PHYSICIANASSISTANT

Individual provider General Practice Physician · NPI 1366927741

Song Kang, PHYSICIANASSISTANT is a Physician Assistant in Decatur, Illinois. Qualified in 2018, 8 years ago. Practices with Memorial Physician Services, a 158-clinician group and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
8
Licensed in
IL, IN
In the registry since
2018
Specialties on file
2

Practice location Address checks out

320 E Central Ave
Decatur, IL 62521-4665
Phone: (217) 877-4694
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 085006761 (IN)
General Practice Physician Taxonomy 208D00000X · Licence 085006761 (IL)

Record details

NPI number1366927741
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedOctober 1, 2018
Last updated in NPPESOctober 10, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Memorial Physician Services — 158 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Decatur