Individual provider Active NPI

Dongwann Kim, D.C.

  • Chiropractor
  • Naperville, IL
National Provider Identifier
1922266196
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010755 Issued in IL
Practice address
1935 Springbrook Square Dr
#107
Naperville, IL 60564-5947
Phone
(630) 357-3818
NPI assigned
May 23, 2008
Last updated
Apr 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038010755 IL Primary

Addresses

Primary practice location

1935 Springbrook Square Dr
#107
Naperville, IL 60564-5947

Mailing address

1935 Springbrook Square Dr
#107
Naperville, IL 60564-5947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000753 IL Practitioner - Chiropractic 5294896577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038010755ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
J&D Spine and Joint Rehab PLLC CurrentSince Oct 29, 2023 Accepting new patients
DK Chiropractic Wellness Center LLC Chiropractor CurrentSince Jun 24, 2012 Accepting new patients

Locations

1935 Springbrook Square Dr
Naperville, IL 60564
Phone (630) 357-3818

1935 Springbrook Square Dr
Ste 105
Naperville, IL 60564
Phone (269) 806-8408

1935 Springbrook Square Dr
Ste 107
Naperville, IL 60564
Phone (630) 357-3818

2920 83rd St
Naperville, IL 60564

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1922266196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 SPRINGBROOK SQUARE DR",
            "address_2": "#107",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 SPRINGBROOK SQUARE DR",
            "address_2": "#107",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645947",
            "telephone_number": "630-357-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONGWANN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.