Kim, Stanley T

Kim, Stanley T is an individual health care provider with primary practice located at 2300 Children'S Plaza, No. 9 Children'S Memorial Hospital, Chicago IL 60614. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Kim, Stanley T can be contacted via phone (773) 880-6792.

Contact Information

Primary practice address
2300 Children'S Plaza, No. 9 Children'S Memorial Hospital Chicago IL 60614
Phone: (773) 880-6792
Fax: (773) 880-3517
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036-111178 Illinois
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036.111178 Illinois
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 151887 California

Profile Details

NPI number 1790779791
LBN Legal business name Kim, Stanley T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2005
Last updated Sep 6th, 2018 - about 6 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 1790779791 NPPES
Illinois Other 021622158 CMMG BLUE SHIELD
Illinois MEDICAID 036111178 CMMG BLUE SHIELD

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