Individual provider Active NPI

Stanley I Kim, MD

  • Hematology & Oncology Physician
  • Maywood, IL
National Provider Identifier
1306940705
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036175029 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Sep 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036175029 IL Primary
Medical Oncology Physician 207RX0202X 22994 NH
Hematology & Oncology Physician 207RH0003X 25272 ME
Medical Oncology Physician 207RX0202X 74165 MN
Hematology & Oncology Physician 207RH0003X MD21077 RI
Hematology & Oncology Physician 207RH0003X A42574 CA

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Other practice location 1

981 W Foothill Blvd
Claremont, CA 91711-3304
Phone (909) 624-7200

Other practice location 2

265 Western Ave Ste 2
South Portland, ME 04106-2458
Phone (207) 661-0200

Other practice location 3

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-2920

Other practice location 4

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5435

Other identifiers 1

IdentifierTypeStateIssuer
00A425740MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI, CO, GU, IL, RI6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20100222000303 CA Practitioner - Hematology/Oncology 2163566175 Reassigns benefits to 1 organization
Practice locations: Claremont, CA; Pomona, CA
I20210512001007 HI Practitioner - Hematology/Oncology 2163566175 Reassigns benefits to 2 organizations
I20220420001130 CO Practitioner - Medical OncologyPractitioner - Internal Medicine 2163566175 Reassigns benefits to 1 organization
I20221122001920 GU Practitioner - Hematology/Oncology 2163566175 Reassigns benefits to 1 organization
I20250616000238 IL Practitioner - Hematology/Oncology 2163566175
I20260219002675 RI Practitioner - Hematology/Oncology 2163566175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians
Queens North Hawaii Community HospitalGroup PAC ID 0143116293, 102 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5435

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 881-4400

Hospital & facility affiliations

  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A42574CAMDHematology & Oncology Physician
036175029ILMDHematology & Oncology Physician
25272MEMDHematology & Oncology Physician
MD21077RIMDHematology & Oncology Physician
22994NHMDMedical Oncology Physician
A71763CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Apr 1, 2026 Accepting new patients
Kern County Hospital Authority CurrentSince Jan 30, 2024 Accepting new patients
Kern County Hospital Authority CurrentSince Jan 30, 2024 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Jul 6, 2022 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Jul 6, 2022 Accepting new patients
Rhode Island Hospital Hematology & Oncology CurrentSince Apr 1, 2026 Accepting new patients
Kauai Medical Clinic CurrentSince Apr 18, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 18, 2022 Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Nov 5, 2022 Accepting new patients
Kauai Medical Clinic CurrentSince Apr 18, 2021 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Apr 18, 2022 Accepting new patients
Intermountain Medical Group Denver, LLC Hematology & Oncology Current Accepting new patients
Kapiolani Medical Center for Women & Children Past Accepting new patients
Vera Dermatology Inc PastSince Feb 6, 2022 Accepting new patients

Locations

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

1111 Columbus St
Bakersfield, CA 93305
Phone (661) 326-5052

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 6

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": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1306940705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "981 W Foothill Blvd",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917113304",
            "country_code": "US",
            "telephone_number": "909-624-7200",
            "fax_number": "909-624-7211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 Western Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041062458",
            "country_code": "US",
            "telephone_number": "207-661-0200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029062853",
            "country_code": "US",
            "telephone_number": "401-793-2920",
            "fax_number": "401-793-2859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5435",
            "fax_number": "401-444-8301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "STANLEY",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036175029",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NH",
            "license": "22994",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ME",
            "license": "25272",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MN",
            "license": "74165",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "RI",
            "license": "MD21077",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A42574",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A425740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.