Organization
DIVISION ANESTHESIA GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUN KYUNG KIM M.D. (CHAIRMAN)
(312) 770-2000
Entity
Organization
Contact information
Practice address
2233 W DIVISION ST, ST. MARY OF NAZARETH HOSPITAL / ANESTHESIA DEPARTMENT, CHICAGO, IL 60622-3043
(312) 770-2000
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(630) 874-2542
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
08/12/2005
Last updated
07/16/2007
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