Keith K Nam, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036043256 Issued in IL

Practice address

3434 W Peterson Ave
Suite 202
Chicago, IL 60659-3319

Phone

(773) 267-0781

Fax

(773) 267-0968

NPI assigned

Oct 19, 2006

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

Other identifiers 2

Other names 1

• Key LLTH Nam Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1922180330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 W PETERSON AVE",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593319",
            "telephone_number": "773-267-0781",
            "fax_number": "773-267-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 W PETERSON AVE",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593319",
            "telephone_number": "773-267-0781",
            "fax_number": "773-267-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "KEITH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036043256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "21603529",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036043256",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEY",
            "last_name": "NAM",
            "middle_name": "LLTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Johanna Graciella Menor Nalupta, MD
• Yuliana Bohdanivna Nalysnyk, APRN, FNP-C
• Denis Nam, M.D., M.SC.
• Ellis Nam, MD
• Joo Yeon Nam, M.D.
• Namasport, Inc.
• Namasturm, LLC
• Lisa Angela Namatame, PA-C
• Sreela Namboodiri
• Alfred Namrood

• Pulmonary Disease Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.