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General NPI Number Information
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NPI Number | 1912925165
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Entity Type | Individual
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Provider Name | KIM W HAMMERBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 12/19/2012
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Provider Practice Location Address
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Address Line | 2211 N. OAK PARK AVE
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City | CHICAGO
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State | IL
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Zip | 60707-3392
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Country | US
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Telephone | 773-622-5400
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Fax | 773-385-5488
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Provider Business Mailing Address
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Address Line | P. O. BOX 8500, LOCKBOX 7642
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City | PHILADELPHIA
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State | PA
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Zip | 19178-7642
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Country | US
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Telephone | 813-281-8115
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Fax | 813-281-8656
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036-058222
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License Number State | IL
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