Active NPI
Kim Macchia
- Other Technician
- Oak Brook, IL
National Provider Identifier
1801617923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 220.000051
- Practice address
- 120 Oakbrook Center Mall Ste 216
Oak Brook, IL 60523-4713 - Phone
- (630) 571-5470
- NPI assigned
- Oct 21, 2024
- Last updated
- Oct 21, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 220.000051 | IL | Primary |
Addresses
Primary practice location
120 Oakbrook Center Mall Ste 216
Oak Brook, IL 60523-4713
Mailing address
145 E Quincy St
Riverside, IL 60546-2175
Phone (708) 785-5515
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 |
|---|---|---|---|
| 220.000051 | IL | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1801617923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 E QUINCY ST",
"city": "RIVERSIDE",
"state": "IL",
"postal_code": "605462175",
"telephone_number": "708-785-5515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 OAKBROOK CENTER MALL STE 216",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605234713",
"telephone_number": "630-571-5470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACCHIA",
"first_name": "KIM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-21",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "IL",
"license": "220.000051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.