Individual
AGNES KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-4149
Mailing address
225 E CHICAGO AVE BOX 23, CHICAGO, IL 60611
(312) 227-4149
Taxonomy
Speciality
Code
Description
License number
State
133VN1401X
Pediatric Critical Care Nutrition Registered Dietitian
Primary
164005768
IL
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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