Individual provider Active NPI

Kimberly J Mercurio, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Westmont, IL
National Provider Identifier
1679878292
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036110532 Issued in IL
Practice address
303 W Ogden Ave
Westmont, IL 60559-1419
Phone
(630) 967-2225
Fax
(630) 428-3971
NPI assigned
Jan 12, 2011
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036110532 IL Primary

Addresses

Primary practice location

303 W Ogden Ave
Westmont, IL 60559-1419

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036110532MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmercurio121275@direct.edward.org
Direct Messaging Address kmercurio228781@dulyhealthandcare.direct-ci.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121026000559 IL Practitioner - Physical Medicine and RehabilitationPractitioner - PsychiatryPractitioner - Hand SurgeryPractitioner - Pain Management 4385894302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management, Psychiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

12004 S Rte
Suite 59
Plainfield, IL 60585-5108
Phone (815) 416-6620

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

1801 S Highland Ave
Lombard, IL 60148-4932
Phone (630) 627-4722

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110532ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jun 15, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 15, 2021 Accepting new patients
Schwab Faculty Associates Inc Physical Medicine & Rehabilitation CurrentSince Aug 4, 2019 Accepting new patients
Gottlieb Community Health Services Corporation Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1401 S California Ave
Chicago, IL 60608
Phone (773) 522-5853

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

28687 Network Pl
Chicago, IL 60673

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

303 W Ogden Ave
Westmont, IL 60559
Phone (630) 435-6107

Interoperability endpoints

  • Direct secure messaging: kmercurio228781@dulyhealthandcare.direct-ci.com

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 4

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": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1679878292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591419",
            "telephone_number": "630-967-2225",
            "fax_number": "630-428-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCURIO",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036110532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110532",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmercurio121275@direct.edward.org",
            "affiliation": "N",
            "address_1": "303 W Ogden Ave",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605591419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmercurio228781@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "303 W Ogden Ave",
            "city": "Westmont",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605591419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.