Provider Demographics
NPI:1437253614
Name:KIM, EUI S (PHARM D, BCPS)
Entity Type:Individual
Prefix:DR
First Name:EUI
Middle Name:S
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARM D, BCPS
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D, BCPS
Mailing Address - Street 1:2557 BRIAN DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-7610
Mailing Address - Country:US
Mailing Address - Phone:708-202-8387
Mailing Address - Fax:708-202-2088
Practice Address - Street 1:FIFTH AVENUE AND ROOSEVELT ROAD
Practice Address - Street 2:HINES VA MEDICAL CENTER
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-4674
Practice Address - Fax:708-202-2088
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0323981835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy