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General NPI Number Information
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NPI Number | 1184618209
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Entity Type | Organization
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Legal Business Name | JOON WOO KIM, M.D., SC.
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 925 HOFFNER DRIVE
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City | GRAYSLAKE
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State | IL
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Zip | 60030
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Country | US
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Telephone | 847-223-6330
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Fax |
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Provider Business Mailing Address
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Address Line | 925 HOFFNER DRIVE
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City | GRAYSLAKE
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State | IL
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Zip | 60030
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Country | US
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Telephone | 847-223-6330
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Fax | 847-223-6382
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOON WOO KIM
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Credential | M.D.
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Telephone | 847-223-6330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 036088083
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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