| Doctor Name: | DR. S THERESA KIM |
| NPI Number: | 1366681421 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 01059631A |
| Business Practice Address: | 5875 N Lincoln Ave Suite 131 Chicago, IL - 606594672 |
| Business Phone Number: | 7738787222 |
| Business Fax Number: | 7738787221 |
| Mailing Address: | 706 W Huntington Commons Rd, #1a MOUNT PROSPECT |
| State: | IL |
| Postal Code: | 600565159 |
| Phone Number: | 8473870911 |
| Fax Number: | 7738787221 |
| NPI Enumeration Date: | 02/12/2009 |
| NPI Last Update Date: | 03/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01059631A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |