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General NPI Number Information
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NPI Number | 1043831894
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Entity Type | Individual
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Provider Name | INAE JANG KIM MD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 6201 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-3888
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Country | US
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Telephone | 708-636-9393
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Fax | 708-636-2022
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Provider Business Mailing Address
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Address Line | 2321 S WABASH AVE APT 9
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City | CHICAGO
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State | IL
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Zip | 60616-4828
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Country | US
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Telephone | 773-702-1150
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.075774
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207WX0120X
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Taxonomy Name | Cornea and External Diseases Specialist Physician
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License Number | 036170383
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 3360170383
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 125.075774
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 036170383
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License Number State | IL
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