MEDICARE: DR. MELISSA ANN DUGAN-KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	125048926	IL

General Provider Information

NPI Number	:	1144409939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA ANN DUGAN-KIM MD

Provider Business Mailing Address
First Line	:	900 N KINGSBURY ST
Second Line	:	SUITE 130-N
City	:	CHICAGO
State	:	IL
Zip	:	60610-7432
Country	:	US
Telephone Number	:	312-775-1100
Fax Number	:	312-775-1111

Provider Business Practice Location Address
First Line	:	900 N KINGSBURY ST
Second Line	:	SUITE 130-N
City	:	CHICAGO
State	:	IL
Zip	:	60610-7432
Country	:	US
Telephone Number	:	312-775-1100
Fax Number	:	312-775-1111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	10/23/2009

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