Basic Information
| Provider Information | |||||||||
| NPI: | 1528017688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIM | ||||||||
| FirstName: | TAEK | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 911 N ELM ST | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | HINSDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605213634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308566865 | ||||||||
| FaxNumber: | 6308566813 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 N OAK ST | ||||||||
| Address2: | |||||||||
| City: | HINSDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605213860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308568900 | ||||||||
| FaxNumber: | 6308568923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 36046678 | IL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.