Active NPI
Sung Kim
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Chicago, IL
National Provider Identifier
1992318935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 051.301720
- Practice address
- 953 W Irving Park Rd
Chicago, IL 60613-2923 - Phone
- (773) 935-6414
- NPI assigned
- Aug 28, 2020
- Last updated
- Aug 28, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 051.301720 | IL | Primary |
Addresses
Primary practice location
953 W Irving Park Rd
Chicago, IL 60613-2923
Mailing address
953 W Irving Park Rd
Chicago, IL 60613-2923
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | rxm.15004@store.walgreens.com | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.301720 | IL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
953 W Irving Park Rd
Chicago, IL 60613
Phone (773) 935-6414
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": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1992318935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "953 W IRVING PARK RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "953 W IRVING PARK RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606132923",
"telephone_number": "773-935-6414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUNG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-28",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "IL",
"license": "051.301720",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "rxm.15004@store.walgreens.com",
"affiliation": "N",
"endpointDescription": "Walgreens email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "953 W Irving Park Rd",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606132923",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.