Provider Demographics
NPI:1750541967
Name:YEONG H. KIM MD, FACC, SC
Entity type:Organization
Organization Name:YEONG H. KIM MD, FACC, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YEONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-301-1212
Mailing Address - Street 1:455 S ROSELLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-2971
Mailing Address - Country:US
Mailing Address - Phone:847-301-1212
Mailing Address - Fax:847-301-1277
Practice Address - Street 1:455 S ROSELLE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2971
Practice Address - Country:US
Practice Address - Phone:847-301-1212
Practice Address - Fax:847-301-1277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036044777207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036044777Medicaid
IL110067930OtherRAILROAD MEDICARE
IL585554OtherAETNA-HMO
IL21603515OtherBLUE CROSS BLUE SHIELD
IL4064400OtherAAETNA-NON HMO
IL4326553004OtherCIGNA
IL585554OtherAETNA-HMO
IL036044777Medicaid