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Organization
JAE KIM, M.D.
Active
Organization
JAE KIM, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAE K KIM M.D. (OWNER)
(309) 671-8749
Entity
Organization
Contact information
Practice address
210 W WALNUT ST, CANTON, IL 61520-2444
(309) 647-5240
(309) 647-5104
Mailing address
7309 N KNOXVILLE AVE, SUITE 200, PEORIA, IL 61614-2085
(309) 691-6225
(309) 691-7635
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036056328
IL
Other
Enumeration date
06/10/2006
Last updated
05/01/2015
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