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Individual

ROGER HOON KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3000
Mailing address
2520 CLAYTON BLVD, CHAMPAIGN, IL 61822-2387
(631) 987-7168

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-144271
IL
2086X0206X
Surgical Oncology Physician
0101241581
VA
2086X0206X
Surgical Oncology Physician
Primary
036-144271
IL
2086X0206X
Surgical Oncology Physician
MD.203302
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036-144271
STATE LICENSE
IL
Enumeration date
07/13/2007
Last updated
11/01/2023
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