Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 036.147820 | IL |
NPI | 1366720245 |
---|---|
Provider Name | Erin D Kim |
First Address | Oak Lawn, IL 60453 |
Second Address | Oak Lawn, IL 60453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2011 |
Last Update Date | 27/12/2021 |