| Organization Name: | TAEK Y. KIM, M.D., S.C. |
| NPI Number: | 1356608665 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAEK Y. KIM (OWNER) |
| Mailing Address: | 6800 Main St Suite 215 Downers Grove |
| State: | IL US |
| Postal Code: | 605163493 |
| Phone Number: | 6309710335 |
| Fax Number: | 6309710364 |
| NPI Enumeration Date: | 04/12/2012 |
| NPI Last Update Date: | 04/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 036046678 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |