Kimberly McKinnon, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036129662 Issued in IL

Practice address

3450 Lacey Rd
Downers Grove, IL 60515-5430

Phone

(630) 743-4500

Fax

(630) 743-4537

NPI assigned

Jul 10, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmckinnon18645@direct.midwestern.edu

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.

• Midwestern University

  • Clinic/Center
  • Downers Grove, IL
  • NPI 1538445317
  Medicare reassignment Care Compare group NPD
• Dr. Susan Rife Family Medicine SC

  • Family Medicine Physician
  • Orland Park, IL
  • NPI 1184602880
  Medicare reassignment NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Edward Health Ventures

  • Clinic/Center
  • Elmhurst, IL
  • NPI 1275963027

  Family Medicine

  NPD
• Midwestern University

  • Optometrist
  • Downers Grove, IL
  • NPI 1295126324
  NPD
• Health Service Systems, Inc

  • Internal Medicine Physician
  • New Lenox, IL
  • NPI 1851323257

  Family Medicine

  NPD (past)
• Macneal Physicians Group LLC

  • Internal Medicine Physician
  • Berwyn, IL
  • NPI 1205024791

  Family Medicine

  NPD (past)
• Midwestern University

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1932206414
  NPD (past)

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1124257241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "KIMBERLY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-10",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036129662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129662",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James R. McKee, DDS
• Lisa Maire McKee, D.D.S.
• Phillip C. McKegg
• Rachael McKenney
• Nancy L McKeon, LCSW
• Hollie Jo McKitrick, RDH
• Daniel L McLachlan, MD
• Russell McLaughlin, M.D.
• Elizabeth Ann McNally, LCSW
• McNamara Chiropractic

• Family Medicine Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.
• 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.