Active NPI
Joon Han Pai, MD
- Pediatrics Physician
- Skokie, IL
National Provider Identifier
1407159452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036.045623
- Practice address
- 7420 Lincoln Ave # C
Skokie, IL 60076-5808 - Phone
- (708) 645-0460
- NPI assigned
- Dec 14, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036.045623 | IL | Primary |
Addresses
Primary practice location
7420 Lincoln Ave # C
Skokie, IL 60076-5808
Mailing address
3637 Falcon Way
Brea, CA 92823-1012
Phone (708) 645-0460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160301001922 | IL | Order and Referring Only - Pediatric Medicine | 9032414966 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.045623 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456099200000",
"number": "1407159452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3637 FALCON WAY",
"city": "BREA",
"state": "CA",
"postal_code": "928231012",
"telephone_number": "708-645-0460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7420 LINCOLN AVE # C",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600765808",
"telephone_number": "708-645-0460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAI",
"first_name": "JOON",
"middle_name": "HAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-14",
"last_updated": "2016-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.045623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.