Ryan Kim, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.018345 Issued in IL

Practice address

14400 John Humphrey Dr Ste 1E
Orland Park, IL 60462-2897

Phone

(708) 671-1500

Fax

(708) 671-1535

NPI assigned

Oct 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1821563370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 JOHN HUMPHREY DR STE 1E",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622897",
            "telephone_number": "708-671-1500",
            "fax_number": "708-671-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 JOHN HUMPHREY DR STE 1E",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622897",
            "telephone_number": "708-671-1500",
            "fax_number": "708-671-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RYAN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.018345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymund Kho
• Saroj Khurana, M.D.
• Kids in Progress, Inc
• Deborah Kilbane
• Vilija Kilikevicius
• Sung-Lana Kim, MD
• Wook S Kim, DDS
• Kimberly Battle-Miller, MD, SC
• Kindred
• Lynn M King Panepinto, LCSW

• Family Nurse Practitioner in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.