Individual provider Active NPI

Oliver S. Kim, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Park Ridge, IL
National Provider Identifier
1699767129
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036106022 Issued in IL
Practice address
1775 Dempster St
Lutheran General Hospital / Pathology Department
Park Ridge, IL 60068-1143
Phone
(847) 723-2210
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036106022 IL Primary

Addresses

Primary practice location

1775 Dempster St
Lutheran General Hospital / Pathology Department
Park Ridge, IL 60068-1143

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address okim237834@direct.myadvocateaurora.org Direct

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
I20051031000702 IL Practitioner - Pathology 5991722738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Wisconsin School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Diagnostic Pathology, S.C.Group PAC ID 7911924428, 44 clinicians

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-2210

Hospital & facility affiliations

  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036106022ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Diagnostic Pathology SC Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2005 Accepting new patients

Locations

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

520 E 22nd St
Lombard, IL 60148
Phone (630) 874-2542

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

Interoperability endpoints

  • Direct secure messaging: okim237834@direct.myadvocateaurora.org

Organizations & group practices 1

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 6

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1699767129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "address_2": "LUTHERAN GENERAL HOSPITAL / PATHOLOGY DEPARTMENT",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "847-723-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "OLIVER",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036106022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "address_2": "Lutheran General Hospital / Pathology Department",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okim237834@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "address_2": "Lutheran General Hospital / Pathology Department",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.