Individual provider Active NPI

Hee H Kim, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1891851622
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036054891 Issued in IL
Practice address
7531 S Stony Island Ave
Suite 153
Chicago, IL 60649-3954
Phone
(773) 947-7534
Fax
(773) 947-7761
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036054891 IL Primary

Addresses

Primary practice location

7531 S Stony Island Ave
Suite 153
Chicago, IL 60649-3954

Mailing address

34 Ramsgate Drive
Palos Park, IL 60464-1420
Phone (708) 361-0808

Other identifiers 1

IdentifierTypeStateIssuer
036054891MedicaidIL

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

State licenses

LicenseStateTypeSpecialty
036054891ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Park Hospital Foundation Current Accepting new patients

Locations

7531 S Stony Island Ave
Ste 153
Chicago, IL 60649
Phone (773) 947-7534

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

Interoperability endpoints

  • Direct secure messaging: heekim@jph.medalliesdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1891851622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 RAMSGATE DRIVE",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641420",
            "telephone_number": "708-361-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "address_2": "SUITE 153",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7534",
            "fax_number": "773-947-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEE",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036054891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054891",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.