DR. TAE WON KIM M.D. NPI 1932148632

NPI Information

NPI: 1932148632
Provider Name: DR. TAE WON KIM, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
355 RIDGE AVE
EVANSTON, IL
ZIP 60202
Phone: (847) 316-6101
Get Directions

DR. Tae Won Kim, M.D. is a diagnostic radiology radiology in Evanston, IL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Tae Won Kim, M.D. NPI is 1932148632. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

355 RIDGE AVE
EVANSTON, IL
ZIP 60202-328
Phone: (847) 316-6101

The NPI 1932148632 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/6/2006 and was last updated on 9/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	036054630	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IL7584043	MEDICARE PIN	ILLINOIS
2	01615776	OTHER	ILLINOIS	BCBS PROVIDER NUMBER
3	P01113996	OTHER	ILLINOIS	RRMC
4	E46738	MEDICARE UPIN	ILLINOIS
5	IL7522021	MEDICARE PIN	ILLINOIS
6	036054630	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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