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1306940705

NPI Code Detail

MEDICARE: DR. STANLEY I KIM MD

MEDICARE: DR. STANLEY I KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	036175029	IL
2	207RX0202X	Medical Oncology Physician	22994	NH
3	207RH0003X	Hematology & Oncology Physician	25272	ME
4	207RX0202X	Medical Oncology Physician	74165	MN
5	207RH0003X	Hematology & Oncology Physician	MD21077	RI
6	207RH0003X	Hematology & Oncology Physician	A42574	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306940705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY I KIM MD

Provider Business Mailing Address
First Line	:	2160 S 1ST AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-3328
Country	:	US
Telephone Number	:	708-216-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2160 S 1ST AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-3328
Country	:	US
Telephone Number	:	708-216-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	02/09/2026

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Directions to “ DR. STANLEY I KIM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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