Shelley S Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-0009187 Issued in IL

Practice address

865 Elmhurst Rd
Des Plaines, IL 60016-5605

Phone

(847) 437-1005

Fax

(847) 437-0755

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Eye Complete Family Eyecare SCGroup PAC ID 2264589324, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Metro Eye Complete Family Eyecare SC

  • Eyewear Supplier
  • Milwaukee, WI
  • NPI 1366680183

  Optometrist

  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1245695378
  Medicare reassignment NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Chicago, IL
  • NPI 1154297752
  NPD
• Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Grayslake, IL
  • NPI 1760847701
  NPD

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1396752846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 ELMHURST RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165605",
            "telephone_number": "847-437-1005",
            "fax_number": "847-437-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SHELLEY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-0009187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan M Kim, MD
• Dasol Kim, MS, RD
• Jennifer Jo Jo Kim, PHD
• Joan Kim
• Rachel Kim, PHARMD
• Rachel Kimbrough
• Elizabeth Louise Lockhart King, MS, CCC-SLP
• Ellie Kirchberg
• Joseph Kirshenbaum, RPH
• Victoria Klem, ANP-C

• Optometrist in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.