Gina Kim, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12190304 Issued in IL

Practice address

1S280 Summit Ave
Court A1
Oakbrook Terrace, IL 60181-6018

Phone

(630) 889-9889

NPI assigned

Jan 16, 2020

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Midwest Illinois Six Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1295493047
  NPD (past)

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1205466364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S 280 SUMMIT AVE",
            "address_2": "STE A1",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "60181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S280 SUMMIT AVE",
            "address_2": "COURT A1",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601816018",
            "telephone_number": "630-889-9889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2451 W Touhy Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606453309",
            "country_code": "US",
            "telephone_number": "773-338-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GINA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F12190304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamed Khalif, R.NCS.T
• Amjad Khan, MD
• Qutaibah Khatib, M.D.
• Krishdeep Khosla, MD
• Kids First Therapy Services Inc.
• Kinnick Medical Limited
• Kathryn Ann Klein, LCPC
• Deborah Klos
• Kloudscript
• Kristopher David Knopp, M.D.

• Family Nurse Practitioner in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.