Individual provider Active NPI

Justin J Kim, MD

  • Infectious Disease Physician
  • Chicago, IL
National Provider Identifier
1578958781
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
036164217 Issued in IL
Practice address
600 S Paulina St Ste 140
Chicago, IL 60612-3806
Phone
(312) 942-5865
NPI assigned
Apr 3, 2015
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 21682 NH
Infectious Disease Physician 207RI0200X 036164217 IL Primary

Addresses

Primary practice location

600 S Paulina St Ste 140
Chicago, IL 60612-3806

Mailing address

600 S Paulina St Ste 140
Chicago, IL 60612-3806
Phone (312) 942-5865

Other practice location 1

One Medical Center Dr
Infectious Disease
Lebanon, NH 03756-0001
Phone (603) 650-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210922002800 NH Practitioner - Infectious DiseasePractitioner - Internal Medicine 0244547040 Reassigns benefits to 2 organizations
I20230821001793 IL Practitioner - Infectious Disease 0244547040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of Virginia School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

600 S Paulina St
Suite 140
Chicago, IL 60612-3806
Phone (312) 942-5865

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209396NCMDDiabetes Educator Registered Nurse
036164217ILMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 1, 2021 Accepting new patients
Rush University Medical Group CurrentSince Sep 1, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 1, 2021 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 1, 2021 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

600 S Paulina St
Ste 140
Chicago, IL 60612
Phone (312) 942-5865

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1578958781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST STE 140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST STE 140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-5865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Medical Center Dr",
            "address_2": "Infectious Disease",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUSTIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NH",
            "license": "21682",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036164217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.