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General NPI Number Information
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NPI Number | 1235352840
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Entity Type | Organization
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Legal Business Name | KIM AND CALVERT, M.D., S.C.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7600 W COLLEGE DR
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1001
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Country | US
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Telephone | 708-448-2438
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Fax | 708-448-2482
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Provider Business Mailing Address
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Address Line | 7600 W COLLEGE DR
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1001
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Country | US
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Telephone | 708-448-2438
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Fax | 708-448-2482
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBRA A SKAS
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Credential |
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Telephone | 708-448-9133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036-03112
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License Number State | IL
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