Individual
EDINA SUNMI KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 996-4020
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036127993
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036127993
STATE LICENSE NUMBER
IL
Enumeration date
05/12/2009
Last updated
05/06/2013
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