Individual provider Active NPI

Stanley Kim, MD

  • Vascular & Interventional Radiology Physician
  • Winfield, IL
National Provider Identifier
1437188018
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036109828 Issued in IL
Practice address
25 N Winfield Rd
Winfield, IL 60190-1295
Phone
(630) 933-2489
Fax
(630) 933-2827
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A71763 CA
Vascular & Interventional Radiology Physician 2085R0204X 036109828 IL Primary

Addresses

Primary practice location

25 N Winfield Rd
Winfield, IL 60190-1295

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 933-2489

Other identifiers 5

IdentifierTypeStateIssuer
00A717630OtherCAMEDI CAL
036109828MedicaidIL
0222075OtherILBLUE CROSS GROUP NUMBER
3631498336019001OtherILCDPG HFS PAYEE ID
3625139096019701OtherILCDH HFS GROUP PAYEE ID

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060317000493 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2860426442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

25 N Winfield Rd
Winfield, IL 60190-1295

25 N Winfield Rd
Winfield, IL 60190-1379
Phone (630) 933-4480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A71763CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Hospital Association CurrentSince Jan 2, 2008 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2025 Accepting new patients
Central Dupage Physician Group CurrentSince Jan 1, 2007 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Northwestern Medical Faculty Foundation Diagnostic Radiology CurrentSince Aug 1, 2025 Accepting new patients
Central Dupage Physician Group Vascular & Interventional Radiology CurrentSince Jan 1, 2007 Accepting new patients
Central Dupage Hospital Association CurrentSince Jan 2, 2008 Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Ste 201
Winfield, IL 60190
Phone (630) 933-4480

25 N Winfield Rd
Ste 401
Winfield, IL 60190
Phone (630) 933-4200

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1437188018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-933-2489",
            "fax_number": "630-933-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-933-2489",
            "fax_number": "630-933-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "STANLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A71763",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036109828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00A717630",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109828",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDH HFS GROUP PAYEE ID",
            "identifier": "3625139096019701",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.