Physician Compare National (NPI:1114214236)

HEALTHCARE PROVIDER: AARON K KIM DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1114214236
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971720483
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140806002647
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KIM
	Individual professional last name
Provider First Name	AARON
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	396 REMINGTON BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 141
	Group Practice or individual's line 2 address
City	BOLINGBROOK
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	604404306
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140065
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVENTIST LA GRANGE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140304
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ADVENTIST BOLINGBROOK HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	M