Kim, Sung Sup
Kim, Sung Sup is an individual health care provider with primary practice located at 5140 N California Ave Suite 465-Gmp, Chicago IL 60625-3645. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Kim, Sung Sup can be contacted via phone (773) 271-8700.Contact Information
Primary practice address
5140 N California Ave Suite 465-Gmp
Chicago IL 60625-3645
Phone: (773) 271-8700
Fax: (773) 271-5912
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036-078576 | Illinois |
Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 036078576 | Illinois |
Profile Details
NPI number | 1700822541 |
---|---|
LBN Legal business name | Kim, Sung Sup |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 21st, 2006 |
Last updated | Apr 12th, 2021 - about 3 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 | 1700822541 | NPPES |
Other | 080066025 | RAILROAD MEDICARE PTAN# | |
Other | DF8696 | RAILROAD MEDICARE PTAN# | |
Other | K39415 | RAILROAD MEDICARE PTAN# | |
MEDICAID | 036078576 | RAILROAD MEDICARE PTAN# | |
Other | 31604584 | RAILROAD MEDICARE PTAN# |
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