Tae Yeon Kim, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036159364 Issued in IL

Practice address

2650 Ridge Ave.
Pediatric Hospitalists
Evanston, IL 60201

Phone

(847) 570-1027

Fax

(847) 733-5108

NPI assigned

Mar 27, 2019

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Pediatrics

  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1104387638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "PEDIATRIC HOSPITALISTS",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-1027",
            "fax_number": "847-733-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "PEDIATRIC HOSPITALISTS",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-1027",
            "fax_number": "847-733-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TAE YEON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036159364",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.159364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer J Kim, M.D.
• Jieun Judy Kim, PHARMD
• Sarah Hyun Kim, MS, CGC
• Sunghyub Kim, DO
• Tae Won Kim, M.D.
• Una O Kim, MD
• Yolanda C Kim, LCSW
• Merikay Kimball
• Valerie A Kimball, M.D.
• Florence W Kimondo, LCSW, PHD

• Hospitalist Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.