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General NPI Number Information
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NPI Number | 1073791794
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Entity Type | Individual
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Provider Name | STEVE KWANGSUN KIM
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Gender | Male
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 4034 W LAWRENCE AVE
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City | CHICAGO
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State | IL
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Zip | 60630-2825
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Country | US
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Telephone | 773-545-3279
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Fax | 773-545-6263
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Provider Business Mailing Address
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Address Line | 1580 SHERMAN AVE 201
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City | EVANSTON
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State | IL
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Zip | 60201-4465
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Country | US
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Telephone | 847-475-8639
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2932
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License Number State | IL
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