Individual provider Active NPI

Kimberly A Seipel-Carrow, MD

  • Pediatric Adolescent Medicine Physician
  • Evanston, IL
National Provider Identifier
1609927417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Practice address
Northwestern University Health Services
633 Emerson
Evanston, IL 60208-0001
Phone
(847) 491-8100
Fax
(847) 491-5919
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X IL Primary

Addresses

Primary practice location

Northwestern University Health Services
633 Emerson
Evanston, IL 60208-0001

Mailing address

Northwestern University Health Services
633 Emerson
Evanston, IL 60208-0001
Phone (847) 491-8100

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036068324ILMDPediatric Adolescent Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609927417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHWESTERN UNIVERSITY HEALTH SERVICES",
            "address_2": "633 EMERSON",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602080001",
            "telephone_number": "847-491-8100",
            "fax_number": "847-491-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHWESTERN UNIVERSITY HEALTH SERVICES",
            "address_2": "633 EMERSON",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602080001",
            "telephone_number": "847-491-8100",
            "fax_number": "847-491-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIPEL-CARROW",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.