Provider Demographics
NPI:1184771172
Name:KIM, SAMUEL SUK (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:SUK
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:675 N SAINT CLAIR ST FL 17
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5975
Mailing Address - Country:US
Mailing Address - Phone:312-695-3800
Mailing Address - Fax:312-695-3644
Practice Address - Street 1:675 N SAINT CLAIR ST FL 17
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-3800
Practice Address - Fax:312-695-3644
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036150342208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)