DR. PETER KIM (NPI# 1114002953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114002953 |
| Entity Type | Individual |
| Full Name | DR. PETER KIM |
| Credential | DDS |
| Practice Address |
1109 West Park Ave Libertyville IL 60048 |
| Practice Telephone | 8473671133 |
| Mailing Telephone | 8473671133 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295298891 | Peter Y Kim | Specialist | 1380 Howard St # 201c, San Francisco, CA 94103-2638 | 2019-04-10 |
| 1922518208 | Peter Kim | Dentist | 15737 E Prentice Dr, Centennial, CO 80015-4264 | 2017-10-02 |
| 1336593391 | Peter Eugene Kim | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Radiology, Albany, NY 12208 | 2016-04-15 |
| 1821475369 | Peter Eusuk Kim | Dentist | 4649 Loma Del Sur Dr, Apt 3307, El Paso, TX 79934-3350 | 2015-05-05 |
| 1497041438 | Peter P Kim | Orthotic Fitter | 720 S. Ramona Ave., Suite 103, Corona, CA 92879-2147 | 2011-06-28 |
| 1184915761 | Peter Hwa Kim | Acupuncturist | 801 N Tustin Ave Ste 501, Santa Ana, CA 92705-3609 | 2011-04-29 |
| 1821257528 | Peter Simon Kim | Podiatrist | 5220 Pacific Concourse Dr, Ste 120, Los Angeles, CA 90045-6244 | 2008-06-06 |
| 1164603965 | Peter Yeon-seong Kim | Internal Medicine | 1400 Pressler, Suite Fct 11.5012, Md Anderson Cancer - Pickens Academic Tower, Houston, TX 77030 | 2007-11-20 |
| 1972725844 | Peter M Kim | Dentist | 2415 G St, Bakersfield, CA 93301-2809 | 2007-05-02 |
| 1053454983 | Peter Sang Kim | Acupuncturist | 929 N Western Ave, Los Angeles, CA 90029-3215 | 2007-02-14 |
| Street Address |
1109 WEST PARK AVE |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1154775195 | Courtney Lamb | Dentist | 1037 Windhaven Rd, Libertyville, IL 60048-3809 | 2016-04-15 |
| 1467850826 | Team Dental | Dentist | 107 W Rockland Rd, Libertyville, IL 60048-2709 | 2014-12-16 |
| 1962815589 | Meggan L Rutledge | Dentist | 1001 W Park Ave, Libertyville, IL 60048 | 2014-06-11 |
| 1700134749 | Lisa Konz, D.d.s., P.C. | Dentist | 747 N. Milwaukee Ave., Suite 103, Libertyville, IL 60048 | 2012-08-23 |
| 1265728224 | Dental Health and Beauty | Dentist | 1109 W Park Ave, Libertyville, IL 60048-2552 | 2011-06-28 |
| 1962622241 | Ludmila Fraszczynski | Dentist | 210 N Butterfield Rd, Libertyville, IL 60048-1757 | 2007-04-27 |
| 1609995471 | Linda L Hime | Dentist | 1025 W. Park Ave., Libertyville, IL 60048-2550 | 2007-03-29 |
| 1609994433 | Ala Dean Attar | Dentist | 712 Florsheim Dr Ste 12, Libertyville, IL 60048-5270 | 2007-03-27 |
| 1316077092 | Meagan Ruth Heilman | Dentist | 1001 W Park Avenue, Libertyville, IL 60048 | 2007-03-06 |
| Find all providers in LIBERTYVILLE | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on DR. PETER KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.