Healthcare Provider Details

I. General information

NPI: 1174448377
Provider Name (Legal Business Name): YEEUN KIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LE FEVRE RD
STERLING IL
61081-1279
US

IV. Provider business mailing address

1822 1ST AVE APT 7
STERLING IL
61081-1261
US

V. Phone/Fax

Practice location:
  • Phone: 815-625-0400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051.306118
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: