Individual
MICHAEL HYUN-OOK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
747 N RUTLEDGE ST, 5TH FLOOR, SPRINGFIELD, IL 62702-6700
(217) 545-8000
(217) 545-7063
Mailing address
7500 MERCY RD, OMAHA, NE 68124-2319
(402) 398-5880
(402) 398-6716
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
31083
NE
207RC0001X
Clinical Cardiac Electrophysiology Physician
036-105331
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD14035
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105331
—
IL
05
—
393667800
—
MN
01
—
IL4720012
MEDICARE PROVIDER NUMBER-LAKE COUNTY
IL
01
—
K30600
MEDICARE PROVIDER NUMBER
IL
Enumeration date
02/10/2006
Last updated
09/24/2018
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