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General NPI Number Information
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NPI Number | 1962439992
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Entity Type | Individual
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Provider Name | JEAN OK KIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 3333 GREEN BAY RD
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3037
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Country | US
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Telephone | 847-578-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-578-3000
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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 | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 40518
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 036-101238
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License Number State | IL
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