Organization Active NPI

Pediatric Medical Services

  • Pediatrics Physician
  • Skokie, IL
National Provider Identifier
1053535591
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC MEDICAL SERVICES
Practice address
9669 Kenton Ave
Ste 403
Skokie, IL 60076-1266
Phone
(847) 674-4730
Fax
(847) 674-4732
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Suna Yi
Title
Office Manager
Phone
(847) 674-4730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

9669 Kenton Ave
Ste 403
Skokie, IL 60076-1266

Mailing address

9669 Kenton Ave
Ste 403
Skokie, IL 60076-1266
Phone (847) 674-4730

Other identifiers 2

IdentifierTypeStateIssuer
1780644120OtherILBERNARD HANKIN, NPI#
1255321873OtherILSUNBUM KIM, NPI#

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0414081Pediatric Medical Services SC9669 Kenton Ave Suite 403, Skokie, IL 60076Certificate of waiverSep 28, 2026

National Provider Directory

National Provider Directory

Locations

9669 Kenton Ave
Ste 403
Skokie, IL 60076
Phone (847) 674-4730

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1053535591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "STE 403",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-674-4730",
            "fax_number": "847-674-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "STE 403",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-674-4730",
            "fax_number": "847-674-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "YI",
        "authorized_official_first_name": "SUNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-674-4730",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BERNARD HANKIN, NPI#",
            "identifier": "1780644120",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUNBUM KIM, NPI#",
            "identifier": "1255321873",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.