Provider Demographics
NPI:1417912734
Name:KIM, KYU-HO (MD, FAAP)
Entity Type:Individual
Prefix:
First Name:KYU-HO
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6S235 STEEPLE RUN DR
Mailing Address - Street 2:STE #201
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-3769
Mailing Address - Country:US
Mailing Address - Phone:630-369-1362
Mailing Address - Fax:630-369-1370
Practice Address - Street 1:6S235 STEEPLE RUN DR
Practice Address - Street 2:STE #201
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3769
Practice Address - Country:US
Practice Address - Phone:630-369-1362
Practice Address - Fax:630-369-1370
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-058361208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics