Active NPI
Jessica Kim
- Social Worker
- Mount Prospect, IL
National Provider Identifier
1760354765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.102902
- Practice address
- 1400 W Lincoln St
Mount Prospect, IL 60056-2927 - Phone
- (312) 767-8202
- NPI assigned
- Sep 19, 2025
- Last updated
- Sep 19, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.102902 | IL | Primary |
Addresses
Primary practice location
1400 W Lincoln St
Mount Prospect, IL 60056-2927
Mailing address
1400 W Lincoln St
Mount Prospect, IL 60056-2927
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.102902 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758240000000",
"number": "1760354765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 W LINCOLN ST",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600562927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 W LINCOLN ST",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600562927",
"telephone_number": "312-767-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-09-19",
"last_updated": "2025-09-19",
"certification_date": "2025-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.102902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Prospect, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.