Active NPI
Kermit Dan Hoyme, MD
- Urology Physician
- Chicago Ridge, IL
National Provider Identifier
1609812759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 036 057763
- Practice address
- 10400 Southwest Hwy
Chicago Ridge, IL 60415-1367 - Phone
- (708) 423-8706
- Fax
- (708) 423-8659
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 036 057763 | IL | Primary |
Addresses
Primary practice location
10400 Southwest Hwy
Chicago Ridge, IL 60415-1367
Mailing address
10400 Southwest Hwy
Chicago Ridge, IL 60415-1367
Phone (708) 423-8706
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036057763 | Medicaid | IL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036 057763 | IL | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265932800000",
"number": "1609812759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 SOUTHWEST HWY",
"city": "CHICAGO RIDGE",
"state": "IL",
"postal_code": "604151367",
"telephone_number": "708-423-8706",
"fax_number": "708-423-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10400 SOUTHWEST HWY",
"city": "CHICAGO RIDGE",
"state": "IL",
"postal_code": "604151367",
"telephone_number": "708-423-8706",
"fax_number": "708-423-8659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOYME",
"first_name": "KERMIT",
"middle_name": "DAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2010-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036 057763",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036057763",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.