Provider Demographics
NPI:1962562835
Name:KIM, SARAH S (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:S
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1275 E. BELVIDERE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030
Mailing Address - Country:US
Mailing Address - Phone:847-740-0300
Mailing Address - Fax:847-740-0309
Practice Address - Street 1:1275 E. BELVIDERE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030
Practice Address - Country:US
Practice Address - Phone:847-740-0300
Practice Address - Fax:847-740-0309
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2009-06-17
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Provider Licenses
StateLicense IDTaxonomies
IL036053437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D93812Medicare UPIN