Individual
BRIAN SANGWOOK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 S WOOD ST STE 100, CHICAGO, IL 60612-4325
(293) 331-2996
Mailing address
820 S WOOD ST STE 100, CHICAGO, IL 60612-4325
(293) 331-2996
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
125084826
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125084826
TEMPORARY MEDICAL LICENSE
IL
Enumeration date
03/21/2024
Last updated
08/21/2024
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