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General NPI Number Information
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NPI Number | 1225656432
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Entity Type | Individual
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Provider Name | JESSICA S KIM
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Gender | Female
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 880 W CENTRAL RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-2355
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Country | US
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Telephone | 847-618-4430
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-982-3362
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 041399309
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 95236442
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 277003499
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95016336
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License Number State | CA
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