Individual
STANLEY T KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 CHILDREN'S PLAZA, NO. 9, CHILDREN'S MEMORIAL HOSPITAL, CHICAGO, IL 60614
(773) 880-6792
(773) 880-3517
Mailing address
2300 CHILDREN'S PLAZA, NO. 9, CHILDREN'S MEMORIAL HOSPITAL, CHICAGO, IL 60614-3363
(773) 880-6792
(773) 880-3517
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036-111178
IL
2085R0202X
Diagnostic Radiology Physician
036.111178
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
151887
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021622158
CMMG BLUE SHIELD
IL
05
—
036111178
—
IL
Enumeration date
09/06/2005
Last updated
09/06/2018
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