Kim, Chang Kwon

Kim, Chang Kwon is an individual health care provider with primary practice located at 0N300 Armstrong Ln , Geneva IL 60134-6081. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Kim, Chang Kwon can be contacted via phone (630) 208-1700.

Contact Information

Primary practice address
0N300 Armstrong Ln Geneva IL 60134-6081
Phone: (630) 208-1700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036060318 Illinois
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036060318 Illinois

Profile Details

NPI number 1104883768
LBN Legal business name Kim, Chang Kwon
Credentials M.D.,F.A.C.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Feb 12th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104883768 NPPES
Illinois MEDICAID 036060318

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