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General NPI Number Information
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NPI Number | 1780882258
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Entity Type | Individual
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Provider Name | JEFFREY KIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 1425 N RANDALL RD
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City | ELGIN
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State | IL
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Zip | 60123-2300
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Country | US
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Telephone | 224-783-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 511 SIXTH AVE 228
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 718-637-4677
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 244511-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A103032
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036158933
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License Number State | IL
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