Individual provider Active NPI

Jessica S Kim

  • Acute Care Nurse Practitioner
  • Arlington Heights, IL
National Provider Identifier
1225656432
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
277003499 Issued in IL
Practice address
880 W Central Rd
Arlington Heights, IL 60005-2355
Phone
(847) 618-4430
NPI assigned
Jul 14, 2020
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 277003499 IL Primary
Acute Care Nurse Practitioner 363LA2100X 95016336 CA
Emergency Registered Nurse 163WE0003X 041399309 IL
Emergency Registered Nurse 163WE0003X 95236442 CA

Addresses

Primary practice location

880 W Central Rd
Arlington Heights, IL 60005-2355

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 982-3362

Other practice location 1

5656 S Maryland ave
Chicago, IL 60637
Phone (773) 702-1220

Other practice location 2

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 703-4496

Other practice location 3

1500 S. California Ave
Chicago, IL 60608
Phone (773) 257-6241

Other identifiers 1

IdentifierTypeStateIssuer
209.021840OtherILDEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220415001217 IL Practitioner - Nurse Practitioner 1456765965 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

209 9TH St
Suite 200
Rockford, IL 61104-2235
Phone (779) 696-2750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041399309ILMDEmergency Registered Nurse
277003499ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Mar 11, 2022 Accepting new patients
Swedishamerican Hospital CurrentSince Sep 2, 2025 Accepting new patients
The University of Chicago Medical Center CurrentSince Mar 11, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 1, 2024 Accepting new patients
Swedishamerican Hospital CurrentSince Sep 2, 2025 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Swedishamerican Hospital Current Accepting new patients

Locations

880 W Central Rd
Arlington Hts, IL 60005
Phone (847) 394-3553

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

209 9th St
Ste 200
Rockford, IL 61104
Phone (779) 696-2750

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

Interoperability endpoints

  • Direct secure messaging: jkim161756@uchospital.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1225656432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-4430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5656 S Maryland ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60637",
            "country_code": "US",
            "telephone_number": "773-702-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-703-4496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S. California Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60608",
            "country_code": "US",
            "telephone_number": "773-257-6241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "277003499",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95016336",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IL",
            "license": "041399309",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "95236442",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "209.021840",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.