Individual
DALE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3114 VILLAGE OFFICE PL, CHAMPAIGN, IL 61822-7680
(217) 378-4807
Mailing address
2403 W SPRINGFIELD AVE, W11, CHAMPAIGN, IL 61821-2883
(847) 422-3045
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051.295560
IL
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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