Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036.111052 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036111052 | IL |
NPI | 1598923005 |
---|---|
Provider Name | Gene Kim |
First Address | Burr Ridge, IL 60527-7594 |
Second Address | Chicago, IL 60637-1447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 08/03/2017 |