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Individual

KIM CECILIA LEUNG-STONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036070938
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0031601962
BCBS PROVIDER #
IL
01
1912186024
GROUP NPI
01
216024
MEDICARE GROUP PTAN
01
261093600
TAXID/FEIN
IL
01
DG9897
RAILROAD MEDICARE GROUP NUMBER
GA
01
K48469
MEDICARE PTAN
IL
01
P00465920
RAILROAD MEDICARE PTAN
Enumeration date
12/07/2005
Last updated
03/23/2015
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