Provider Demographics
NPI:1194958587
Name:KIM, YOUNG SUN (MD)
Entity type:Individual
Prefix:
First Name:YOUNG
Middle Name:SUN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5634 S THURLOW ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5128
Mailing Address - Country:US
Mailing Address - Phone:708-269-2949
Mailing Address - Fax:630-590-5105
Practice Address - Street 1:37W755 IL ROUTE 38
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-7507
Practice Address - Country:US
Practice Address - Phone:630-208-2098
Practice Address - Fax:630-513-1473
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036105165207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine