Individual
JISOON KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5673
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-6536
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/04/2012
Last updated
01/27/2016
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