Individual provider Active NPI

Christine Kwon, DO

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1396249751
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036158856 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036158856 IL Primary
Emergency Medicine Physician 207P00000X 1396249751 IL

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckwon114232@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210923001526 CA Practitioner - Emergency Medicine 3577813443 Reassigns benefits to 1 organization
I20220131001709 IL Practitioner - Emergency Medicine 3577813443 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1396249751ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Dimas Emergency Medical Associates Inc. Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Insight Chicago, Inc. CurrentSince Nov 23, 2021 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Insight Chicago, Inc. CurrentSince Nov 23, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 2, 2023 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Aug 15, 2023 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1396249751",
    "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": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "CHRISTINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036158856",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "1396249751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckwon114232@direct.luhs.org",
            "affiliation": "Y",
            "endpointDescription": "ckwon114232@direct.luhs.org",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.