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NPI Code Detail

MEDICARE: DR. YOONJU KIM

MEDICARE: DR. YOONJU KIM
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
1122300000XDentist019027635IL

General Provider Information

NPI Number : 1730348525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YOONJU KIM
Provider Business Mailing Address
First Line : 2353 W BELDEN AVE APT 3S
Second Line :
City : CHICAGO
State : IL
Zip : 60647-6750
Country : US
Telephone Number : 847-682-7968
Fax Number :
Provider Business Practice Location Address
First Line : 1651 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5321
Country : US
Telephone Number : 773-698-8752
Fax Number : 773-830-7107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2008
Last Update Date : 07/06/2014

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Directions to “ DR. YOONJU KIM ” Practice Location

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