Jane Kim, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149021812 Issued in IL

Practice address

9248 N Callero Dr
Niles, IL 60714-1318

Phone

(847) 347-0231

NPI assigned

May 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 2, 2024 through Jan 2, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jane Kim LCSW, LLC

  • Adult Mental Health Clinic/Center
  • Niles, IL
  • NPI 1952982282
  NPD Authorized official
• Garden Health Group LLC

  • Clinical Psychologist
  • River Forest, IL
  • NPI 1639975881
  NPD

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1346863842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9248 N CALLERO DR",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141318",
            "telephone_number": "847-347-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9248 N CALLERO DR",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141318",
            "telephone_number": "847-347-0231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Glen Ellyn",
            "state": "IL",
            "postal_code": "601375839",
            "country_code": "US",
            "telephone_number": "630-866-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5408 N Long Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606301321",
            "country_code": "US",
            "telephone_number": "630-866-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Mallory Kayes, COTA/L
• Kenneth S. Toth, M.D.,S.C.
• Sargon Khamo, M.A.
• Zeba Khan, PHARMD
• Artur Kieloch
• Kyung S Kim, M.D.
• Mary Grace Kim, D.D.S.
• Sung Youn Kim, O.D.
• Young Hee Kim
• Kingsway Home Health Services,Inc

• Clinical Social Worker in Niles, IL
• Providers in Niles, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.