Doctor Name: | DR. BYOUNG O KIM |
NPI Number: | 1811063423 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 454 W Boughton Rd Suite C Bolingbrook, IL - 604401378 |
Business Phone Number: | 6307590088 |
Business Fax Number: | 6307594505 |
Mailing Address: | 454 W Boughton, Suite C BOLINGBROOK |
State: | IL |
Postal Code: | 604401378 |
Phone Number: | 6307590088 |
Fax Number: | 6307594505 |
NPI Enumeration Date: | 11/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |