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:
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Health care specialties

SpecialtyCodeLicense #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 5 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 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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