Individual provider Active NPI

Kimberly Knox, N.P.

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1518159953
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-004750 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637
Phone
(773) 702-1000
NPI assigned
Aug 9, 2007
Last updated
Jun 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-004750 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637

Mailing address

5841 S Maryland Ave
Chicago, IL 60637-1447
Phone (773) 702-1000

Other practice location 1

800 E 55th St
Chicago, IL 60615-4906
Phone (773) 702-0660

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100730000801 IL Practitioner - Nurse Practitioner 3971636713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friend Family Health Center IncGroup PAC ID 2062494552, 36 clinicians

Practice addresses (Care Compare)

6250 S Cottage Grove Ave
Chicago, IL 60637-2530
Phone (773) 702-0660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-004750ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Friend Family Health Center Inc CurrentSince Dec 23, 2017 Accepting new patients
Friend Family Health Center Inc CurrentSince Dec 23, 2017 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients

Locations

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1518159953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 55th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606154906",
            "country_code": "US",
            "telephone_number": "773-702-0660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOX",
        "first_name": "KIMBERLY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-004750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.