Kim, Jinsup

Kim, Jinsup is an individual health care provider with primary practice located at 1890 Silver Cross Blvd , New Lenox IL 60451-9524. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kim, Jinsup can be contacted via phone (815) 300-1450.

Contact Information

Primary practice address
1890 Silver Cross Blvd New Lenox IL 60451-9524
Phone: (815) 300-1450
Fax: (815) 300-4703
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036059465 Illinois

Profile Details

NPI number 1225093750
LBN Legal business name Kim, Jinsup
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jan 17th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225093750 NPPES
Illinois MEDICAID 036059465

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