NPIMap

Individual provider Active NPI

Kimberly Sue Scanlon, DO

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1073526463
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-095831 Issued in IL
Practice address
908 N Elm St Ste 103
Hinsdale, IL 60521-3635
Phone
(630) 789-8890
Fax
(630) 789-8892
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-095831 IL Primary

Addresses

Primary practice location

908 N Elm St Ste 103
Hinsdale, IL 60521-3635

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036095831MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kscanlon15066@direct.edward.org
Direct Messaging Address kscanlon15066@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111206000042 IL Practitioner - Family Practice 5890960769 Reassigns benefits to 1 organization
Practice locations: Western Springs, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

5600 S Wolf Rd
Suite 110
Western Springs, IL 60558-2268
Phone (708) 246-4155

Hospital & facility affiliations

  • Uchicago Medicine Adventhealth Home Care Home health agency, La Grange, IL, CCN 147207
  • Luxe Home Health Home health agency, Des Plaines, IL, CCN 148317
  • Astra Health Home health agency, Harwood Heights, IL, CCN 148259
  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
  • Uchicago Medicine Adventhealth la Grange Hospital, La Grange, IL, CCN 140065
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
  • Edward Hospital Hospital, Naperville, IL, CCN 140231
  • Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036-095831ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jun 1, 2012 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 1, 2012 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

908 N Elm St
Ste 103
Hinsdale, IL 60521
Phone (630) 286-5060

5600 Wolf Rd
Ste 110
Western Springs, IL 60558
Phone (708) 246-4155

5600 Wolf Rd
Western Springs, IL 60558
Phone (312) 246-7222

Interoperability endpoints

  • Direct secure messaging: kscanlon15066@direct.edward.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1073526463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 N ELM ST STE 103",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213635",
            "telephone_number": "630-789-8890",
            "fax_number": "630-789-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-095831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095831",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscanlon15066@direct.edward.org",
            "affiliation": "N",
            "address_1": "5600 Wolf Rd",
            "address_2": "Suite 110",
            "city": "Western Springs",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605582254",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscanlon15066@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "908 N Elm St Ste 103",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.