NPIMap

Individual provider Active NPI

Stephen Byungchul Kwak, DO

  • Diagnostic Radiology Physician
  • Lake Forest, IL
National Provider Identifier
1831517580
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036152630 Issued in IL
Practice address
1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone
(847) 234-5600
Fax
(847) 535-7847
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OT016043 PA
Diagnostic Radiology Physician 2085R0202X 125066173 IL
Diagnostic Radiology Physician 2085R0202X 036152630 IL Primary

Addresses

Primary practice location

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone (847) 234-5600

Other practice location 1

200 Lothrop St
Pittsburgh, PA 15213-2582
Phone (412) 648-6062

Other practice location 2

1900 W. Harrison St.
Dept of Radiology
Chicago, IL 60612
Phone (312) 864-3826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200721003103 IL Practitioner - Diagnostic Radiology 4789980129 Reassigns benefits to 2 organizations
I20260202000148 IA Practitioner - Diagnostic Radiology 4789980129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians
Henry County Health Center IncGroup PAC ID 9638570740, 52 clinicians

Practice addresses (Care Compare)

4001 Oak Ave
Northbrook, IL 60062-4924
Phone (319) 768-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT016043PAMDInternal Medicine Physician
036152630ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Dec 1, 2025 Accepting new patients
University of Pittsburgh Physicians Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Henry County Health Center, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Henry County Health Center Inc CurrentSince Dec 1, 2025 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

407 S White St
Mt Pleasant, IA 52641
Phone (319) 385-6110

1051 Essington Rd
Joliet, IL 60435
Phone (815) 726-1818

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1831517580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-234-5600",
            "fax_number": "847-535-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-234-5600",
            "fax_number": "847-535-7847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lothrop St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132582",
            "country_code": "US",
            "telephone_number": "412-648-6062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 W. Harrison St.",
            "address_2": "Dept of Radiology",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60612",
            "country_code": "US",
            "telephone_number": "312-864-3826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWAK",
        "first_name": "STEPHEN",
        "middle_name": "BYUNGCHUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT016043",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125066173",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036152630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.