Active NPI
Jessica S Kim
- Acute Care Nurse Practitioner
- Arlington Heights, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 277003499
- Practice address
- 880 W Central Rd
Arlington Heights, IL 60005-2355 - Phone
- (847) 618-4430
- NPI assigned
- Jul 14, 2020
- Last updated
- Dec 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209.021840 | Other | IL | DEPARTMENT 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 041399309 | IL | MD | Emergency Registered Nurse |
| 277003499 | IL | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients | |
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | 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
- 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.
-
dba SwedishAmerican Medical Group
- Family Medicine Physician
- Rockford, IL
- NPI 1962451732
-
dba NorthShore University HealthSystem Faculty Practice Associates
- Allergy & Immunology Physician
- Evanston, IL
- NPI 1497701882
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
dba NorthShore Anesthesia Group
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
-
- Family Medicine Physician
- Rockford, IL
- NPI 1073675187
-
- Community/Retail Pharmacy
- Rockford, IL
- NPI 1306635982
-
dba UCMC Pharmacy Services
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Endeavor Health Northwest Community Hospital
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1578932869
-
dba Endeavor Health Northwest Community Hospital
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1770531600
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.