DR. KWANG SOO KIM (NPI# 1578956579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578956579 |
| Entity Type | Individual |
| Full Name | DR. KWANG SOO KIM |
| Credential | M.D. |
| Practice Address |
6475 N Tower Ct Lincolnwood IL 60712-4207 |
| Practice Telephone | 8476764757 |
| Mailing Telephone | 8476764757 |
| Enumeration Date | 2015-03-15 |
| Last Update Date | 2015-03-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085D0003X |
Radiology Specialization: Diagnostic Neuroimaging |
036044452 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122812 | Kwang Kim | Student in an Organized Health Care Education/Training Program | 16201 Northern Blvd # 790, Flushing, NY 11358-1634 | 2020-04-02 |
| 1063994721 | Kwang Il Kim | Counselor | 322 Nw 5th Ave Ste 301b, Portland, OR 97209-3828 | 2018-08-29 |
| 1881901619 | Kwang Jib Kim | Dentist | 594 N. Indian Hill Blvd., Pomona, CA 91767-5302 | 2010-08-31 |
| 1417183047 | Kwang Cho Kim | Psychiatry & Neurology | 3745 Charter Pl, Ann Arbor, MI 48105-2826 | 2009-06-10 |
| 1205074838 | Kwang Han Kim | Dentist | 39150 Sundale Dr, Apt #102, Fremont, CA 94538-2068 | 2009-02-04 |
| 1861656498 | Kwang Kim | Pharmacist | 7350 N Kilbourn Ave, Lincolnwood, IL 60712-1809 | 2008-07-13 |
| 1003035114 | Kwang Seob Kim | Dentist | 18250 Colima Rd, 201, Rowland Heights, CA 91748-2602 | 2007-04-25 |
| 1578611356 | Kwang Jin Kim | Dentist | 3300 W Rosecrans Ave, Suite 105, Hawthorne, CA 90250-8218 | 2007-01-08 |
| 1356437842 | Kwang Hyun Kim | Dentist | 670 Las Gallinas Ave, San Rafael, CA 94903-3687 | 2006-10-04 |
| 1285725051 | Kwang Sook Kim | General Practice | 9636 Garden Grove Blvd # 16, Garden Grove, CA 92844-1530 | 2006-09-27 |
| Street Address |
6475 N TOWER CT |
| City | LINCOLNWOOD |
| State | IL |
| Zip Code | 60712-4207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255998811 | Better Residential Care | Adult Companion | 7301 N. Lincoln Avenue, Suite 104, Lincolnwood, IL 60712 | 2019-05-20 |
| 1538652441 | Elysium Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 7366 N Lincoln Ave Ste 304, Lincolnwood, IL 60712 | 2018-06-14 |
| 1851805253 | Jasmine Lukose | Nurse Practitioner | 6501 N. Lincoln Ave, Lincolnwood, IL 60712 | 2017-11-21 |
| 1982134425 | Sana Baig | Dentist | 4368 W Touhy Ave, Lincolnwood, IL 60712 | 2017-06-18 |
| 1447640081 | Soghra Sorouri | Dentist | 6838 N. Kilpatrick Ave, Lincolwood, IL 60712 | 2015-02-04 |
| 1164839239 | Sunrise Nursing & Rehabilitation Center | Skilled Nursing Facility | 7383 N Lincon Ave, Suite 100, Lincolnwood, IL 60712 | 2014-07-21 |
| 1013328079 | Lawrence S. Reiner | Dentist | 4751 W. Touhy Ave, Lincolnwood, IL 60712 | 2014-05-13 |
| 1437430121 | Susan B Sorisho | Pharmacist | 7318 N East Prairie Rd, Lincolnwood, IL 60712 | 2011-09-08 |
| 1922338623 | Dean Medical, Sc | Internal Medicine | 6501 N. Sauganash, Lincolnwood, IL 60712 | 2010-01-04 |
| 1134456064 | Leah Brennan | Marriage & Family Therapist | 6834 N. Lowell Ave., Lincolnwood, IL 60712 | 2009-11-13 |
| Find all providers in zip 60712 | ||||
| Taxonomy Code | 2085D0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Neuroimaging |
| A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging. |
| Notes: Source: American Academy of Neurology, www.aan.com [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104476670 | Nyssa Perkins | Radiology | 4717 N Knoxville Ave, Peoria, IL 61614-6111 | 2019-09-17 |
| 1134770258 | Conventions Rx, Ltd | Radiology | 1560 Wall St Ste 304, Naperville, IL 60563-1262 | 2019-09-20 |
| 1336701770 | Sreeshma Tellapuri | Radiology | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2019-07-06 |
| 1295213874 | Elie Barakat | Radiology | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2018-08-05 |
| 1134643364 | Mustafa Anwer Jasim Mafraji | Radiology | 1653 W Congress Pkwy Dept Of, Chicago, IL 60612-3833 | 2017-07-30 |
| 1962924902 | Nisa Cem Oren | Radiology | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2017-07-12 |
| 1609216399 | Ramya Santhosh Gaddikeri | Radiology | 1653 W Congress Pkwy, Chicago, IL 60612-3833 | 2013-06-27 |
| 1568604726 | Mariah Haider Bashir | Radiology | 2160 S 1st Ave, Dept of Radiology, Maywood, IL 60153-3328 | 2009-04-01 |
| 1578772570 | Milroy S Emmanuel | Radiology | 4955 N Milwaukee Ave, Suite 1, Chicago, IL 60630-2286 | 2007-05-22 |
| City | LINCOLNWOOD |
| Zip Code | 60712 |
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| 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.