Active NPI
Kwang Soo Steve Kim, D.D.S.
- General Practice Dentistry
- Glenview, IL
National Provider Identifier
1023286556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- IL-019-023098
- Practice address
- 2640 Patriot Blvd
Suite #270
Glenview, IL 60026-8075 - Phone
- (847) 901-6553
- Fax
- (847) 901-6588
- NPI assigned
- Feb 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL-019-023098 | IL | Primary |
Addresses
Primary practice location
2640 Patriot Blvd
Suite #270
Glenview, IL 60026-8075
Mailing address
2640 Patriot Blvd
Suite #270
Glenview, IL 60026
Phone (847) 901-6553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IL-019-023098 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1023286556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2640 PATRIOT BLVD",
"address_2": "SUITE #270",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "60026",
"telephone_number": "847-901-6553",
"fax_number": "847-901-6588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2640 PATRIOT BLVD",
"address_2": "SUITE #270",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268075",
"telephone_number": "847-901-6553",
"fax_number": "847-901-6588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KWANG SOO",
"middle_name": "STEVE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-19",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "IL-019-023098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.