Provider Demographics
NPI:1821237017
Name:NORTH SHORE CONSULTANTS IN NEPHROLOGY & HYPERTENSION, SC
Entity Type:Organization
Organization Name:NORTH SHORE CONSULTANTS IN NEPHROLOGY & HYPERTENSION, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-607-5871
Mailing Address - Street 1:28 W LAKE ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2709
Mailing Address - Country:US
Mailing Address - Phone:630-607-5871
Mailing Address - Fax:630-628-9610
Practice Address - Street 1:2859 CENTRAL ST
Practice Address - Street 2:SUITE 133
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1234
Practice Address - Country:US
Practice Address - Phone:630-607-5871
Practice Address - Fax:630-628-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099773207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty