Organization Active NPI

Chicago Pain and Rehabilitation Clinic P.C.

  • Rehabilitation Practitioner
  • Lincolnwood, IL
National Provider Identifier
1154560530
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
CHICAGO PAIN AND REHABILITATION CLINIC P.C.
Practice address
7300 N Cicero Ave
Lincolnwood, IL 60712-1641
Phone
(847) 763-8010
NPI assigned
Feb 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Dr. David Young Sik Kim
Title
Medical Director
Phone
(847) 763-8010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 225400000X IL Primary

Addresses

Primary practice location

7300 N Cicero Ave
Lincolnwood, IL 60712-1641

Mailing address

7300 N Cicero Ave
Lincolnwood, IL 60712-1641

Other identifiers 1

IdentifierTypeStateIssuer
366760OtherMEDICARE PTAN

Other names 1

  • Chicago Pain and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

Locations

7300 N Cicero Ave
Lincolnwood, IL 60712
Phone (847) 763-8010

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1154560530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 N CICERO AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 N CICERO AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121641",
            "telephone_number": "847-763-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO PAIN AND REHABILITATION CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "YOUNG SIK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-763-8010",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "366760",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Pain and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincolnwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.