| NPI | 1851729370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUJIN KIM President 847-912-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016005437) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: IL 016005437) |
| 213ER0200X Podiatrist Radiology (Licence: IL 016005437) | |
| 213ES0000X Podiatrist Sports Medicine (Licence: IL 016005437) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016005437) | |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2013-10-18 |