John Kimball

Key facts

NPI

1972066199

Entity type

Individual (NPI type 1)

Primary specialty

Radiation Oncology Physician 2085R0001X

License

036170529 (IL)

Practice address

5841 S Maryland Ave
Chicago, IL 60637-1443

Phone

(773) 702-0817

NPI assigned

Apr 14, 2019

Sex

Male

Sole proprietor

Yes

Organizations & group practices 7

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.

• University of Chicago Multi-Specialty Clinic/Center · Chicago, IL · NPI 1821048786
  Medicare reassignment Care Compare group NPD IL · IN
• The Board of Trustees of the University of Illinois Anatomic Pathology Physician · Chicago, IL · NPI 1386863819
  Medicare reassignment NPD IL
• The University of Chicago Medical Center General Acute Care Hospital · Chicago, IL · NPI 1033218128
  Medicare reassignment NPD IL
• University of Chicago Urgent Care Clinic/Center · Chicago, IL · NPI 1477262046
  Care Compare group
• Board of Trustees of the University of Illinois Radiation Oncology Physician · Chicago, IL · NPI 1669691788
  NPD RADIATION ONCOLOGY
• The Board of Trustees of the University of Illinois Occupational Medicine Physician · Chicago, IL · NPI 1043727571
  NPD
• The University of Chicago Medical Center Community/Retail Pharmacy · Calumet City, IL · NPI 1255895678
  NPD

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ingalls Memorial Hospital General Acute Care Hospital · Harvey, IL · NPI 1598756686
  Care Compare affiliation Hospital
• Presence Chicago Hospitals Network General Acute Care Hospital · Chicago, IL · NPI 1679659585
  Care Compare affiliation Hospital
• Silver Cross Hospital & Medical Centers Rehabilitation Hospital Unit · New Lenox, IL · NPI 1003933797
  Care Compare affiliation Hospital
• Silver Cross Hospital & Medical Centers General Acute Care Hospital · New Lenox, IL · NPI 1568553519
  Care Compare affiliation Hospital
• The University of Chicago Medical Center General Acute Care Hospital · Chicago, IL · NPI 1508956509
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Radiation Oncology

Education

University of Miami, LM Miller School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Chicago (1,674 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital · Chicago, IL · CCN 140088
• Ingalls Memorial Hospital Hospital · Harvey, IL · CCN 140191
• Presence Saint Joseph Hospital - Chicago Hospital · Chicago, IL · CCN 140224
• Silver Cross Hospital and Medical Centers Hospital · New Lenox, IL · CCN 140213

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in IL, IN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkimball322091@uchospital.direct-ci.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 15, 2024.

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1972066199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-0817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-996-3631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "323 Harry Hines Mc9159",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753900001",
            "country_code": "US",
            "telephone_number": "770-634-2027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036170529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Chicago, IL · Radiation Oncology Physician in Illinois