Provider Demographics
NPI:1588756696
Name:KEVIN K. SOHN, M.D., S.C.
Entity type:Organization
Organization Name:KEVIN K. SOHN, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:KIWON
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-593-9191
Mailing Address - Street 1:637 E GOLF RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4967
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:637 E GOLF RD
Practice Address - Street 2:SUITE 208
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4967
Practice Address - Country:US
Practice Address - Phone:847-593-9191
Practice Address - Fax:847-593-9203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E57893Medicare UPIN
IL530770Medicare ID - Type Unspecified