Ellen E Kim, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

036109301 Issued in IL

Practice address

225 E Chicago Ave # 54
Chicago, IL 60611-2991

Phone

(312) 227-6091

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekim161234@direct.carenet.org

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.

• Lurie Children'S Medical Group Inc

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1518064716
  Medicare reassignment NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • O Fallon, IL
  • NPI 1477076263
  Medicare reassignment NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1457203135
  NPD
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1891709440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "NWT 1230 CB 8116",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6051",
            "fax_number": "314-454-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 54",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-6091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Pl Ste C",
            "address_2": "Ste C",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101002",
            "country_code": "US",
            "telephone_number": "314-454-6051",
            "fax_number": "314-454-6225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELLEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2017013312",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MO",
            "license": "2017013312",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036109301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donghyun Kim, OD
• Doo Hyun Kim, DDS
• Dustin Kim
• Edina Sunmi Kim, M.D.
• Elissa Minju Kim, DDS
• Ellis Y Kim, MD
• Erica Hawon Kim
• Erin Kim, MD
• Esther Kim, LPC
• Esther Kim, PHARM.D

• Pediatric Endocrinology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Endocrinology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.