| NPI | 1578132411 |
|---|---|
| Doing Business As | RICHARD KIM |
| Entity Type | Organization |
| Authorized Contact | RICHARD KIM Clinical Director 224-938-9521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-06-29 |