Sung Sup Kim, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036078576 Issued in IL

Practice address

5140 N California Ave
Suite 465-GMP
Chicago, IL 60625-3645

Phone

(773) 271-8700

Fax

(773) 271-5912

NPI assigned

Jun 21, 2006

Last updated

Apr 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Sung Sup Kim M.D. P.C.

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1205933355
  Authorized official Same address or phone

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1700822541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE",
            "address_2": "SUITE G 465",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-271-8700",
            "fax_number": "773-271-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE",
            "address_2": "SUITE 465-GMP",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-271-8700",
            "fax_number": "773-271-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUNG",
        "middle_name": "SUP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-078576",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036078576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "K39415",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078576",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN#",
            "identifier": "DF8696",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31604584",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN#",
            "identifier": "080066025",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skim277040@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5140 N California Ave",
            "address_2": "SUITE G 465",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606253645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven Kim
• Sumin Kim, LAPC, ATR
• Sun Wha Kim, R.PH
• Sung Kim
• Sung Kim
• Susan S. Kim, M.D.
• Susie Kim, PT, DPT
• Tae Min Kim
• Tae Woo Kim, MD
• Teresa S. Kim, M.D.

• Interventional Cardiology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.