Individual provider Active NPI

Jean Ok Kim, M.D.

  • Pediatric Infectious Diseases Physician
  • North Chicago, IL
National Provider Identifier
1962439992
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
036-101238 Issued in IL
Practice address
3333 Green Bay Rd
North Chicago, IL 60064-3037
Phone
(847) 578-3000
NPI assigned
Jun 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 40518 IA
Pediatric Infectious Diseases Physician 2080P0208X 036-101238 IL Primary

Addresses

Primary practice location

3333 Green Bay Rd
North Chicago, IL 60064-3037

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 578-3000

Other identifiers 5

IdentifierTypeStateIssuer
347713028OtherILPTAN MCHENRY
036-101238MedicaidIL
347710033OtherILPTAN COOK
347711014OtherILPTAN DUPAGE
IL3289017OtherILPTAN WILL

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jkim150392@direct.luhs.org Direct LOYOLA UNIVERSITY MEDICAL CENTER
Direct Messaging Address jkim230991@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041115000923 IL Practitioner - Pediatric MedicinePractitioner - Infectious Disease 1658335153 Reassigns benefits to 2 organizations
I20230524001416 VA Practitioner - Pediatric Medicine 1658335153 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-101238ILMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake CurrentSince Aug 26, 2024 Accepting new patients
County of Lake CurrentSince Aug 26, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
County of Lake Current Accepting new patients
Loyola University Medical Center Current Accepting new patients
Childrens Specialty Group PLLC CurrentSince Jun 15, 2023 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 27, 2019 Accepting new patients
The Board of Trustees of the University of Illinois Pediatric Infectious Diseases CurrentSince Jan 27, 2019 Accepting new patients
County of Lake Past Accepting new patients

Locations

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

515 Keller Ave
Waukegan, IL 60085
Phone (847) 377-8700

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Interoperability endpoints

  • Direct secure messaging: jean.kim.p1@direct.lakecountyil.nextgenshare.com
  • Direct secure messaging: jkim230991@direct.myadvocateaurora.org

Organizations & group practices 9

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1962439992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-578-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037",
            "telephone_number": "847-578-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEAN",
        "middle_name": "OK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "IA",
            "license": "40518",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "IL",
            "license": "036-101238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN MCHENRY",
            "identifier": "347713028",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-101238",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN COOK",
            "identifier": "347710033",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN DUPAGE",
            "identifier": "347711014",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN WILL",
            "identifier": "IL3289017",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkim150392@direct.luhs.org",
            "affiliation": "Y",
            "endpointDescription": "jkim150392@direct.luhs.org",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkim230991@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1675 Dempster St Fl 3",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1675 Dempster St Fl 3",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.