Organization
LISA KIM MEDICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA S KIM MD (PRESIDENT)
(847) 296-1200
Entity
Organization
Contact information
Practice address
2604 DEMPSTER ST, SUITE 300, PARK RIDGE, IL 60068-8427
(847) 296-1200
(847) 296-7913
Mailing address
2604 DEMPSTER ST, SUITE 300, PARK RIDGE, IL 60068-8427
(847) 296-1200
(847) 296-7913
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620216
BCBS
IL
Enumeration date
09/07/2006
Last updated
08/22/2020
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