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General NPI Number Information
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NPI Number | 1932114451
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Entity Type | Organization
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Legal Business Name | DONG S KIM MD SC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 9700 N KENTON AVE STE K202
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City | SKOKIE
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State | IL
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Zip | 60076
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Country | US
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Telephone | 847-933-3555
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Fax | 847-933-3559
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Provider Business Mailing Address
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Address Line | 489 WILLOW RD
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City | WINNETKA
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State | IL
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Zip | 60093-4140
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Country | US
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Telephone | 847-933-3555
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Fax | 847-933-3559
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DONG S KIM
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Credential | MD
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Telephone | 847-933-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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