Individual
DR. SUNG-LANA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10719 WEST 160TH STREET, ORLAND PARK, IL 60467
(708) 226-3300
(708) 226-4202
Mailing address
75 REMITTANCE DRIVE, SUITE 6581, CHICAGO, IL 60675-6581
(708) 226-3300
(708) 226-4202
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036-091407
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-091407
STATE LICENSE
IL
01
—
036091407
BLUE CROSS BLUE SHIELD PROVIDER NUMBER
IL
01
—
200029585
RAILROAD MEDICARE PROVIDER NUMBER
IL
Enumeration date
05/18/2006
Last updated
12/22/2021
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