| Lisa Kim Medical Associates Sc | |
|
2604 Dempster St Suite 300 Park Ridge IL 60068-8427 | |
| (847) 296-1200 | |
| (847) 296-7913 |
| Full Name | Lisa Kim Medical Associates Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2604 Dempster St, Park Ridge, Illinois |
| Authorized Official Name and Position | Lisa S Kim (PRESIDENT) |
| Authorized Official Contact | 8472961200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Kim Medical Associates Sc 2604 Dempster St Suite 300 Park Ridge IL 60068-8427 Ph: (847) 296-1200 | Lisa Kim Medical Associates Sc 2604 Dempster St Suite 300 Park Ridge IL 60068-8427 Ph: (847) 296-1200 |
| NPI Number | 1285737700 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3678653656 |
|---|---|
| Medicare Enrollment ID | O20080103000159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285737700 | NPI | - | NPPES |
| 01620216 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| Provider Name | Lisa S Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942341250 PECOS PAC ID: 7012032717 Enrollment ID: I20100918000070 |
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