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General NPI Number Information
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NPI Number | 1003914771
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Entity Type | Individual
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Provider Name | MIN KYUNG KIM MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 1200 S. YORK #3160
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 331-221-9095
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Fax | 331-221-3996
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Provider Business Mailing Address
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Address Line | 172 SCHILLER
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 331-221-9095
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Fax | 331-221-3996
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 036116817
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License Number State | IL
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