Kimberly Elise Portale, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

20A13356 Issued in CA

Practice address

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099

Phone

(618) 234-2120

NPI assigned

Jun 19, 2012

Last updated

Aug 7, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Obstetrics/Gynecology

Education

Kansas City College of Medicine and Surgery, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obhg Illinois SCGroup PAC ID 7810179702, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS St Elizabeth's Hospital Hospital, O Fallon, IL, CCN 140187

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Obhg Illinois SC

  • Obstetrics & Gynecology Physician
  • Berwyn, IL
  • NPI 1700107216
  Medicare reassignment Care Compare group NPD

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

• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  dba HSHS St. Elizabeth's Hospital

  • General Acute Care Hospital
  • O'Fallon, IL
  • NPI 1629057302
  Care Compare affiliation

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1134482656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627810001",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 W Losey St",
            "address_purpose": "LOCATION",
            "city": "Scott AFB",
            "state": "IL",
            "postal_code": "622255250",
            "country_code": "US",
            "telephone_number": "618-256-7018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTALE",
        "first_name": "KIMBERLY",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036169160",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A13356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amillia Polk, LPN
• Emily Pollman
• Sydney Pollmann, APRN
• Kevin M Ponciroli, M.D.
• Aurelia Popp
• Rece Portell, PA
• Amy Jean Porter, MS, CCC-SLP/L
• Shayla Porter, RBT
• Jordan Portner
• Caitlin Elizabeth Poths, RBT

• Obstetrics & Gynecology Physician in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.