Provider Demographics
NPI:1447529730
Name:HEE HAN KIM MD SC
Entity type:Organization
Organization Name:HEE HAN KIM MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEE
Authorized Official - Middle Name:HAN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-947-7534
Mailing Address - Street 1:7531 S STONY ISLAND AVE
Mailing Address - Street 2:SUITE #153
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3954
Mailing Address - Country:US
Mailing Address - Phone:773-947-7534
Mailing Address - Fax:
Practice Address - Street 1:7531 S STONY ISLAND AVE
Practice Address - Street 2:SUITE #153
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3954
Practice Address - Country:US
Practice Address - Phone:773-947-7534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty