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Contact Information

JEONG N KIM JUDD, MD
2160 SOUTHERN ILLINOIS ROUTE 157
STE B
GLEN CARBON, IL62034-1720
 Phone: 618-692-1212
 Fax: 618-692-4875
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JEONG N KIM JUDD · (Female)

NPI Number 1013100122
Status Active
Credentials MD
Entity Individual
Enumeration date 08/22/2007
Last updated 10/07/2016 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # IL036128909
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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