Individual
ELIZA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
210 N BOLINGBROOK DR, BOLINGBROOK, IL 60440-2386
(630) 972-4010
Mailing address
210 N BOLINGBROOK DR, BOLINGBROOK, IL 60440-2386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019033216
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2020
Last updated
08/30/2021
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