Organization
KIM & MIZERA SURGICAL ASSOCIATES SC
Active
Other names
STEVEN S KIM MD SC
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN S. KIM M.D. (PRESIDENT)
(773) 275-4496
Entity
Organization
Contact information
Practice address
5140 N CALIFORNIA AVE STE 560, CHICAGO, IL 60625-2577
(773) 275-4496
(773) 784-6141
Mailing address
5140 N CALIFORNIA AVE STE 560, CHICAGO, IL 60625-2577
(773) 275-4496
(773) 784-6141
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036097666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213876
GROUP PTIN
IL
Enumeration date
08/08/2006
Last updated
05/24/2010
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