Individual provider Active NPI

Angela Christine Yim

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1790538924
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125.083211 Issued in IL
Practice address
5841 S Maryland Ave # Mc3077
Chicago, IL 60637-1443
Phone
(773) 702-0529
NPI assigned
Apr 8, 2024
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125.083211 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc3077
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1790538924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC3077",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "ANGELA",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.083211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.