Individual provider Active NPI

Kiev Anh Huynh

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1275265944
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG03220112 Issued in IL
Practice address
5715 N Maplewood Ave
Chicago, IL 60659-5117
Phone
(773) 780-9297
NPI assigned
Jun 30, 2022
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG03220112 IL Primary

Addresses

Primary practice location

5715 N Maplewood Ave
Chicago, IL 60659-5117

Mailing address

5715 N Maplewood Ave
Chicago, IL 60659-5117
Phone (773) 780-9297

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
I20230220001389 IL Practitioner - Nurse Practitioner 4082086087 Reassigns benefits to 2 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
Family Wound Care Physicians IncGroup PAC ID 7719413665, 3 clinicians

Practice addresses (Care Compare)

4001 W Devon Ave
Suite 210
Chicago, IL 60646-4537
Phone (773) 983-6204

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG03220112ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Wound Care Physicians Inc CurrentSince Nov 25, 2024 Accepting new patients
Advanced Wound Care Associates PLLC Nurse Practitioner CurrentSince Jul 1, 2024 Accepting new patients
Kidney Specialists of Illinois LLC CurrentSince Apr 20, 2023 Accepting new patients
Family Care Physicians Inc CurrentSince Dec 1, 2022 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Feb 16, 2023 Accepting new patients
Cook County CurrentSince Feb 16, 2023 Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

4001 W Devon Ave
Ste 210
Chicago, IL 60646
Phone (773) 283-8488

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

6374 N Lincoln Ave
Ste 201
Chicago, IL 60659
Phone (773) 501-6203

5540 W 111th St
Ste 2
Oak Lawn, IL 60453
Phone (708) 424-7600

Interoperability endpoints

  • Direct secure messaging: kiev.huynh.1@24172.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1275265944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 N MAPLEWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606595117",
            "telephone_number": "773-780-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5715 N MAPLEWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606595117",
            "telephone_number": "773-780-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "KIEV",
        "middle_name": "ANH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "AG03220112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.