Individual
TONG SU KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3434 W PETERSON AVE, 1C, CHICAGO, IL 60659
(773) 267-8060
(847) 251-7177
Mailing address
3434 W PETERSON AVE, 1C, CHICAGO, IL 60659
(773) 267-8060
(847) 251-7177
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301037885
MI
208000000X
Pediatrics Physician
A33664
CA
208000000X
Pediatrics Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21607071
BCBS
—
Enumeration date
07/21/2006
Last updated
07/08/2007
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