Individual
JI MIN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
259 E ERIE ST, CHICAGO, IL 60611-2987
(312) 695-4517
Mailing address
680 N LAKE SHORE DR, CHICAGO, IL 60611-4546
(312) 695-6868
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
209014282
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209014282
IL
Other
Enumeration date
05/17/2016
Last updated
11/02/2018
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