Provider Demographics
NPI:1366852188
Name:KIM, HYEYEONG (ACT)
Entity Type:Individual
Prefix:
First Name:HYEYEONG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 DUNDEE RD STE 402
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2452
Mailing Address - Country:US
Mailing Address - Phone:224-203-5001
Mailing Address - Fax:
Practice Address - Street 1:3100 DUNDEE RD STE 402
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:224-203-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001188171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist