Individual
GINNA J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 362-2905
Mailing address
105 WILLOW PKWY, BUFFALO GROVE, IL 60089-6608
(847) 567-3123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041329165
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209007882
IL
Other
Enumeration date
11/20/2009
Last updated
01/03/2014
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