Active NPI
Kimberly Joseph, M.D.
- Surgery Physician
- Chicago, IL
National Provider Identifier
1447372115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036081051
- Practice address
- 1900 W Polk St
Department of Trauma, Room 1300
Chicago, IL 60612-3723 - Phone
- (312) 864-2740
- Fax
- (312) 864-9169
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Critical Care Physician | 2086S0102X | 036081051 | IL | |
| Trauma Surgery Physician | 2086S0127X | 036081051 | IL | |
| Surgery Physician | 208600000X | 036081051 | IL | Primary |
Addresses
Primary practice location
1900 W Polk St
Department of Trauma, Room 1300
Chicago, IL 60612-3723
Mailing address
4226 N Kolmar Ave
Chicago, IL 60641-1900
Phone (312) 864-2740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593129600000",
"number": "1447372115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4226 N KOLMAR AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606411900",
"telephone_number": "312-864-2740",
"fax_number": "312-864-9169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 W POLK ST",
"address_2": "DEPARTMENT OF TRAUMA, ROOM 1300",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123723",
"telephone_number": "312-864-2740",
"fax_number": "312-864-9169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2020-06-26",
"certification_date": "2020-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "IL",
"license": "036081051",
"primary": false
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "IL",
"license": "036081051",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036081051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.