Individual
KRISTINE C KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
333 MADISON ST, JOLIET, IL 60435-8200
(815) 725-7133
Mailing address
8986 COPPERGATE RD, WOODRIDGE, IL 60517-7559
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041416770
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209028815
IL
Other
Enumeration date
06/06/2023
Last updated
11/17/2023
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