MEDICARE: DR. JOSEPH SUN KIM DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	016004326	IL
2	213E00000X	Podiatrist	016004326	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	IL5729	OTHER	IL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821096785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH SUN KIM DPM

Provider Business Mailing Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:	STE 515
City	:	CHICAGO
State	:	IL
Zip	:	60625-3645
Country	:	US
Telephone Number	:	773-989-1699
Fax Number	:	773-989-1698

Provider Business Practice Location Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:	STE 515
City	:	CHICAGO
State	:	IL
Zip	:	60625-3645
Country	:	US
Telephone Number	:	773-989-1699
Fax Number	:	773-989-1698

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	10/08/2021

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Directions to “ DR. JOSEPH SUN KIM DPM” Practice Location

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