Provider Demographics
NPI:1003844895
Name:KIM, JEE HOON (DC)
Entity Type:Individual
Prefix:DR
First Name:JEE
Middle Name:HOON
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 W CHICAGO AVE
Mailing Address - Street 2:2 FL.
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4723
Mailing Address - Country:US
Mailing Address - Phone:773-252-9740
Mailing Address - Fax:773-252-9746
Practice Address - Street 1:2317 W CHICAGO AVE
Practice Address - Street 2:2 FL.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4723
Practice Address - Country:US
Practice Address - Phone:773-252-9740
Practice Address - Fax:773-252-9746
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL239200Medicare ID - Type UnspecifiedMEDICARE NUMBER