Organization Active NPI

Illumihealth LTD

  • Internal Medicine Physician
  • Vernon Hills, IL
National Provider Identifier
1780432740
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ILLUMIHEALTH LTD
Practice address
270 Center Dr Ste 120
Vernon Hills, IL 60061-1564
Phone
(224) 800-1060
NPI assigned
May 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Dr. Tommy Kwak, MDNPI 1235472820
Title
President
Phone
(224) 800-1060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

270 Center Dr Ste 120
Vernon Hills, IL 60061-1564

Mailing address

270 Center Dr Ste 120
Vernon Hills, IL 60061-1564

Other names 1

  • ELUMIMED Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240705001706 IL Part B Supplier - Clinic/Group Practice 6507300290 Receives reassigned benefits from 1 practitioner
Practice locations: Vernon Hills, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2308809Elumimed270 Center Dr - Ste 120, Vernon Hills, IL 60061Certificate of waiverAug 4, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1780432740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CENTER DR STE 120",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CENTER DR STE 120",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611564",
            "telephone_number": "224-800-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMIHEALTH LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "KWAK",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-800-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELUMIMED",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.