Individual
JUNG E KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7530 WOODWARD AVE, WOODRIDGE, IL 60517-3100
(630) 910-1177
(630) 910-6995
Mailing address
7530 WOODWARD AVE, WOODRIDGE, IL 60517-3100
(630) 910-1177
(630) 910-6995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-103739
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103739
—
IL
01
—
363468127
TAX ID NO
IL
Enumeration date
09/29/2006
Last updated
12/19/2011
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