Provider Demographics
NPI:1942286976
Name:KIM, DANIEL U (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:U
Last Name:KIM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1505 EASTLAND DR
Mailing Address - Street 2:LL 1400
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3534
Mailing Address - Country:US
Mailing Address - Phone:309-663-4700
Mailing Address - Fax:309-665-0575
Practice Address - Street 1:1505 EASTLAND DR
Practice Address - Street 2:LL 1400
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3534
Practice Address - Country:US
Practice Address - Phone:309-663-4700
Practice Address - Fax:309-665-0575
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2009-10-23
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Provider Licenses
StateLicense IDTaxonomies
IL036106917207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine