Kim, Shelly Z

Kim, Shelly Z is an individual health care provider with primary practice located at 464 W Half Day Rd , Buffalo Grove IL 60089-6555. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kim, Shelly Z can be contacted via phone (847) 913-5545.

Contact Information

Primary practice address
464 W Half Day Rd Buffalo Grove IL 60089-6555
Phone: (847) 913-5545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046010494 Illinois

Profile Details

NPI number 1932497161
LBN Legal business name Kim, Shelly Z
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2011
Last updated Oct 30th, 2013 - 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 1932497161 NPPES
Illinois Other 211019 MEDICARE
Illinois MEDICAID 046010494 MEDICARE
Illinois Other 210209 MEDICARE
Illinois Other 8825444 MEDICARE
Illinois Other 7235044 MEDICARE
Illinois Other 1636706 MEDICARE
Illinois Other 502720049 MEDICARE

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