Lisa Kim Medical Associates SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LISA KIM MEDICAL ASSOCIATES SC

Practice address

2604 Dempster St
Suite 300
Park Ridge, IL 60068-8427

Phone

(847) 296-1200

Fax

(847) 296-7913

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Lisa S Kim, MDNPI 1942341250

Title

President

Phone

(847) 296-1200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Lisa Sunhee Kim, M.D.

  • Internal Medicine Physician
  • Park Ridge, IL
  • NPI 1942341250
  Medicare reassignment NPD Authorized official
• Jay A Kim, RPH

  • Pharmacist
  • Park Ridge, IL
  • NPI 1790916724
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285737700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 300",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688427",
            "telephone_number": "847-296-1200",
            "fax_number": "847-296-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 300",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688427",
            "telephone_number": "847-296-1200",
            "fax_number": "847-296-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA KIM MEDICAL ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-296-1200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01620216",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rima Lintakas, DPT
• Angelica Lipiszko
• Joshua Lawrence Lipschultz, PH.D., BCBA-D
• Susan D Lis, M.D.
• Lisa a. Ditchek, Psy.D., P.C.
• Little Hill Psychology Clinic, Inc.
• Little Wildflowers Therapies LLC
• Miranda Liu
• Siyuan Christopher Liu, MD/PHD
• Vivian K Liu, BSN, MSN, CPNP

• Internal Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.