NPIMap

Individual provider Active NPI

Theresa Kim

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1609132984
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36139633 Issued in IL
Practice address
1901 W. Harrison St.
Chicago, IL 60612-9985
Phone
(312) 864-0394
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 036-139633 IL
Emergency Medicine Physician 207P00000X 36139633 IL Primary

Addresses

Primary practice location

1901 W. Harrison St.
Chicago, IL 60612-9985

Mailing address

1901 W. Harrison St.
Chicago, IL 60612-9985
Phone (312) 864-0394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160706001847 IL Practitioner - Emergency Medicine 5890087167 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

  • John H Stroger Jr Hospital Hospital, Chicago, IL, CCN 140124

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36139633ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Board of Trustees of the University of Illinois Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Cook County Emergency Medicine CurrentSince Apr 21, 2017 Accepting new patients
Endeavor Health Medical Group Emergency Medicine CurrentSince Apr 17, 2018 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County CurrentSince Apr 21, 2017 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 1, 2016 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 17, 2018 Accepting new patients

Locations

808 S Wood St
#722
Chicago, IL 60612
Phone (312) 355-0865

2320 E 93rd St
Chicago, IL 60617
Phone (773) 967-2000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

9532 Eagle Way
Chicago, IL 60678

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1609132984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W. HARRISON ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606129985",
            "telephone_number": "312-864-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W. HARRISON ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606129985",
            "telephone_number": "312-864-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "IL",
            "license": "036-139633",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "36139633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.