Individual
DR. PETER S. KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
821 POPLAR ST, HIGHLAND, IL 62249-1658
(618) 654-1281
(618) 654-1452
Mailing address
P.O. BOX 9, HIGHLAND, IL 62249
(618) 654-1281
(618) 654-1452
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036090402
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213743
PTAN
IL
Enumeration date
05/11/2006
Last updated
04/06/2016
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