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General NPI Number Information
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NPI Number | 1407809635
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Entity Type | Individual
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Provider Name | SUNG-LANA KIM MD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 10719 WEST 160TH STREET
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City | ORLAND PARK
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State | IL
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Zip | 60467
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Country | US
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Telephone | 708-226-3300
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Fax | 708-226-4202
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Provider Business Mailing Address
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Address Line | 75 REMITTANCE DRIVE SUITE 6581
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City | CHICAGO
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State | IL
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Zip | 60675-6581
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Country | US
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Telephone | 708-226-3300
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Fax | 708-226-4202
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 036-091407
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License Number State | IL
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