Individual
DR. JASON YUNGSUP KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3420 ILLINOIS ST, USS TRANQUILLITY CLINIC 1007, GREAT LAKES, IL 60088-3161
(847) 688-6755
(847) 688-6179
Mailing address
340 ILLINOIS STREET, USS TRANQUILLITY MEDICAL CLINIC 1007, GREAT LAKES, IL 60088-5230
(847) 688-6755
(847) 688-7425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301038461
MI
Other
Enumeration date
09/13/2007
Last updated
07/26/2010
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