Kimberly Zoellick, FNP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

209.016380 Issued in IL

Practice address

8100 W 119TH St Ste 400
Palos Park, IL 60464-3080

Phone

(708) 361-3300

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FHAJBA/Endpoint/FHAJBA

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.

• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• Southwest Pediatrics, LTD.

  • Pediatrics Physician
  • Palos Park, IL
  • NPI 1427094416
  NPD (past)

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1104344431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 W 119TH ST STE 400",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604643080",
            "telephone_number": "708-361-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 W 119TH ST STE 400",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604643080",
            "telephone_number": "708-361-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOELLICK",
        "first_name": "KIMBERLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016380",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "209.016380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Kay York, RBT 17-27938
• Hong Jun Yun, MD
• Jeneen Zahdan, DDS
• Bernadette Zajaczkowski
• Michael William Zidek, RPH

• Pediatrics Physician in Palos Park, IL
• Providers in Palos Park, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.