Active NPI
Myoung Duck Kim, MD
- Physical Medicine & Rehabilitation Physician
- Oak Lawn, IL
National Provider Identifier
1871654293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Practice address
- 4440 W 95TH St
Oak Lawn, IL 60453-2600 - Phone
- (708) 684-5428
- Fax
- (708) 684-2079
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | IL | Primary |
Addresses
Primary practice location
4440 W 95TH St
Oak Lawn, IL 60453-2600
Mailing address
777 Oakmont LN
Suite 1600
Westmont, IL 60559-5511
Phone (630) 789-2550
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36354817309 | Other | IL | ADVOCATE HEALTH PARTNERS |
| 1619540 | Other | IL | BCBS PROVIDER ID |
| 01621490 | Other | IL | BCBS PROVIDER ID |
| 47625 | Other | IL | ADVOCATE HEALTH CENTERS |
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)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hari Agrawal MD SC | Physical Medicine & Rehabilitation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Medicine & Rehabilitation Physician
- Chicago, IL
- NPI 1730266073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1871654293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 OAKMONT LN",
"address_2": "SUITE 1600",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605595511",
"telephone_number": "630-789-2550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532600",
"telephone_number": "708-684-5428",
"fax_number": "708-684-2079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MYOUNG",
"middle_name": "DUCK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVOCATE HEALTH PARTNERS",
"identifier": "36354817309",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "1619540",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "01621490",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVOCATE HEALTH CENTERS",
"identifier": "47625",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.