Individual
KEE DONG SHIN
Active
Individual
KEE DONG SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-052151
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002201217
BLUECROSS
IL
05
—
036052151
—
IL
01
—
363142614
FEDERAL TAX ID
IL
Enumeration date
09/01/2006
Last updated
06/20/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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