Provider Demographics
NPI:1750530911
Name:KIM, GLORIA (MD)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3825 HIGHLAND AVE
Mailing Address - Street 2:SUITE 3K
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1589
Mailing Address - Country:US
Mailing Address - Phone:630-968-2144
Mailing Address - Fax:630-968-2337
Practice Address - Street 1:3825 HIGHLAND AVE
Practice Address - Street 2:SUITE 3K
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1589
Practice Address - Country:US
Practice Address - Phone:630-968-2144
Practice Address - Fax:630-968-2337
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036116293207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology