Kim, Ray S
Kim, Ray S is an individual health care provider with primary practice located at 500 Coventry Ln Suite 205, Crystal Lake IL 60014-7579. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Kim, Ray S can be contacted via phone (815) 455-7100.Contact Information
Primary practice address
500 Coventry Ln Suite 205
Crystal Lake IL 60014-7579
Phone: (815) 455-7100
Fax: (815) 455-3951
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 071-005373 | Illinois |
Profile Details
NPI number | 1912906116 |
---|---|
LBN Legal business name | Kim, Ray S |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 19th, 2005 |
Last updated | Jul 5th, 2012 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1912906116 | NPPES |
Illinois | Other | 05619771 | BCBS |
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