Active NPI
Jennifer Kim, PHARM.D
- Pharmacist
- Wilmette, IL
National Provider Identifier
1306268883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051297365
- Practice address
- 3232 Lake Ave
Wilmette, IL 60091-1073 - Phone
- (847) 251-1413
- NPI assigned
- Jan 17, 2014
- Last updated
- Jan 17, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051297365 | IL | Primary |
Addresses
Primary practice location
3232 Lake Ave
Wilmette, IL 60091-1073
Mailing address
200 Wilmont Rd
Deerfield, IL 60015
Phone (847) 940-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3777095 | Other | IL | UNITED HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051297365 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389916800000",
"number": "1306268883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WILMONT RD",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "60015",
"telephone_number": "847-940-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3232 LAKE AVE",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600911073",
"telephone_number": "847-251-1413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JENNIFER",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-17",
"last_updated": "2014-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051297365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "3777095",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmette, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.