JAE H KIM (NPI# 1225055866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225055866 |
| Entity Type | Individual |
| Full Name | JAE H KIM |
| Credential | MD |
| Practice Address |
10400 Southwest Hwy Chicago Ridge IL 60415-1367 |
| Practice Telephone | 7084238706 |
| Practice Fax Number | 7084238659 |
| Mailing Telephone | 7084238706 |
| Mailing Fax Number | 7084238659 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036 096031 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036096031 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558778100 | Jae Kim | Pharmacist | 14474 37th Ave, 1st Floor, Flushing, NY 11354-5934 | 2014-07-15 |
| 1215274865 | Jae S. Kim | Dentist | 1025 N Fillmore St, A, Arlington, VA 22201-6701 | 2013-01-15 |
| 1306112875 | Jae Hee Kim | Pharmacist | 1202 N 10th Pl Apt 1214, Renton, WA 98057-5635 | 2012-03-28 |
| 1548531536 | Jae Chil Kim | Physical Medicine & Rehabilitation | 107 Redcliff Dr, Jefferson Hills, PA 15025-3139 | 2012-01-23 |
| 1407143191 | Jae Man Kim | Acupuncturist | 3409 W Burbank Blvd, Burbank, CA 91505-2233 | 2011-07-01 |
| 1609168327 | Jae Y Kim | Otolaryngology | 2200 Wilson Blvd Ste 102-219, Arlington, VA 22201-3397 | 2011-05-12 |
| 1689849176 | Jae Hyun Kim | Prosthetist | 1918 Coliseum Blvd, Greensboro, NC 27403-3211 | 2008-04-25 |
| 1477745388 | Jae Woo Kim | Dentist | 403 N Five Points Rd, West Chester, PA 19380-4632 | 2007-08-14 |
| 1083832273 | Jae Gwon Kim | Dentist | 777 N. Rainbow Blvd., Ste. 395, Las Vegas, NV 89107 | 2007-04-23 |
| 1043359482 | Jae Seung Kim | Acupuncturist | 3400 W Olympic Bl, Ste207, Los Angeles, CA 90019-2122 | 2007-02-05 |
| Street Address |
10400 SOUTHWEST HWY |
| City | CHICAGO RIDGE |
| State | IL |
| Zip Code | 60415-1367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932109337 | Robert E Share | Radiology | 10400 Southwest Hwy, Lower Level, Chicago Ridge, IL 60415-1367 | 2005-07-28 |
| 1689236960 | Core Anesthesia Pllc | Anesthesiology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2019-07-08 |
| 1124339072 | Lisa E Wright | Dietitian, Registered | 10400 Southwest Hwy, Lower Level, Chicago Ridge, IL 60415-1367 | 2010-06-25 |
| 1750616223 | Erin Elizabeth Swiatek | Physician Assistant | 10400 Southwest Hwy, Lower Level, Chicago Ridge, IL 60415-1367 | 2009-10-16 |
| 1710126032 | Associated Urological Specialists LLC | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2009-02-10 |
| 1306050471 | Laura Marie Seweryn | Dietitian, Registered | 10400 Southwest Hwy, Lower Level, Chicago Ridge, IL 60415-1367 | 2007-05-09 |
| 1720122005 | Aaron D Berger | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1427 | 2007-02-19 |
| 1467471540 | Associated Urological Specialists, LLC | Radiology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-07-19 |
| 1629008164 | John N Defranco | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-07-03 |
| 1831128123 | Stephen R Nold | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396233854 | All American Physical Therapy P.C. | Clinic/Center | 9830 Ridgeland Ave Ste 3a, Chicago Ridge, IL 60415 | 2018-04-30 |
| 1841711561 | Limitless Transportation of Illinois | Non-emergency Medical Transport (VAN) | 6726 107th St Unit 2c, Chicago Ridge, IL 60415 | 2017-07-03 |
| 1376927293 | Fariha Querishi | Dentist | 6501 W 95th Street, Chicago Ridge, IL 60415 | 2015-07-10 |
| 1780958603 | Delores Jean Jackson | Occupational Therapy Assistant | 10300 Southwest Highway, Chicago Ridge, IL 60415 | 2012-02-24 |
| 1376855395 | Aa1 Medicar Transpotation Inc | Non-emergency Medical Transport (VAN) | 10624 S Major St 2n, Chicago Ridge, IL 60415 | 2010-07-07 |
| 1952591448 | Orion Diagnostic & Chiropractic Center | Chiropractor | 9830 S. Ridgeland Ave, Suite # 5, Chicago Ridge, IL 60415 | 2007-07-31 |
| 1518006808 | Christopher John Green | Dentist | 6422 W 107th St, Chicago Ridge, IL 60415 | 2007-02-05 |
| 1376697383 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 320 Chicago Ridge Mall # C15, Chicago Ridge, IL 60415 | 2007-01-23 |
| 1144372194 | Ikechukwu Oguejiofor | Urology | 10400 S0uthwest Highway, Chicago Ridge, IL 60415 | 2007-01-18 |
| 1306909148 | Edward Philip Mann | Ophthalmology | 5850 W 111th St, Chicago Ridge, IL 60415 | 2006-12-19 |
| Find all providers in zip 60415 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144372194 | Ikechukwu Oguejiofor | Urology | 10400 S0uthwest Highway, Chicago Ridge, IL 60415 | 2007-01-18 |
| 1710126032 | Associated Urological Specialists LLC | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2009-02-10 |
| 1720122005 | Aaron D Berger | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1427 | 2007-02-19 |
| 1629008164 | John N Defranco | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-07-03 |
| 1831128123 | Stephen R Nold | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-07-01 |
| 1578592770 | Herbert M User | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-07-01 |
| 1609812759 | Kermit Dan Hoyme | Urology | 10400 Southwest Hwy, Chicago Ridge, IL 60415-1367 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1912436015 | Robert Ara Petrossian | Urology | 301 N 8th St # 4b143c, Springfield, IL 62701-1041 | 2017-06-12 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1619337912 | George Robert Buckun | Urology | 930 Rogers St., #301, Downers Grove, IL 60515 | 2016-02-29 |
| 1275991606 | Nicole Alyssa Hamilton | Urology | 22285 N Pepper Rd Ste 201, Lake Barrington, IL 60010-2540 | 2016-01-30 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1386053759 | Ramiro Felix Prudencio | Urology | 1200 Broadmeadow Rd, Winnetka, IL 60093-3707 | 2014-08-10 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| Find all providers with the same taxonomy | ||||
| City | CHICAGO RIDGE |
| Zip Code | 60415 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.