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General NPI Number Information
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NPI Number | 1225041445
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Entity Type | Individual
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Provider Name | YOU S KIM MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 370 LARRY POWER RD SUITE 1
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City | BOURBONNAIS
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State | IL
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Zip | 60914-5194
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Country | US
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Telephone | 815-937-3515
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Fax | 815-935-4916
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Provider Business Mailing Address
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Address Line | 370 LARRY POWER RD SUITE 1
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City | BOURBONNAIS
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State | IL
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Zip | 60914-5194
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Country | US
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Telephone | 815-937-3515
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Fax | 815-935-4916
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036062285
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License Number State | IL
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