STEPHEN KIM (NPI# 1285175109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285175109 |
| Entity Type | Individual |
| Full Name | STEPHEN KIM |
| Credential | C.O. |
| Practice Address |
2434 W Peterson Ave Chicago IL 60659-4113 |
| Practice Telephone | 7738782445 |
| Mailing Telephone | 7738782445 |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2017-03-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | 213.000297 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912444779 | Stephen Kim | Specialist/Technologist | 175 Sam Sibley Dr., Natchitoches, LA 71457 | 2017-01-31 |
| 1265765473 | Stephen Joseph Kim | Dentist | 1200 112th Ave Ne Ste B275, Bellevue, WA 98004-3738 | 2009-09-08 |
| 1043434483 | Stephen Hojong Kim | Dentist | 4061 Kirkpatrick Ln, Suite 100, Flower Mound, TX 75028 | 2007-04-13 |
| 1760539068 | Stephen Sae Chang Kim | Family Medicine | 177 Mouse Creek Rd Nw, Cleveland, TN 37312-3838 | 2007-01-05 |
| 1659449791 | Stephen Kim | Dentist | 7841 Commonwealth Ave, Buena Park, CA 90621-2422 | 2006-11-30 |
| 1376563403 | Stephen Alan Kim | Family Medicine | 3140 Legacy Dr Ste 720, Frisco, TX 75034-7917 | 2006-07-20 |
| 1740226893 | Stephen S Kim | Internal Medicine | 222 Ne Park Plaza Dr, Suite 100, Vancouver, WA 98684-5895 | 2006-06-20 |
| 1558909408 | Stephen Kim | Pharmacist | 1540 E Highland Ave, San Bernardino, CA 92404-4614 | 2019-12-11 |
| 1851750400 | Stephen Kim | Dentist | 5545 E Broadway Blvd Ste 107, Tucson, AZ 85711 | 2016-02-10 |
| 1225387848 | Stephen S Kim | Pharmacist | 2201 Se Loop 820, Fort Worth, TX 76119-5863 | 2012-08-29 |
| Street Address |
2434 W PETERSON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60659-4113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083661797 | Gema | Prosthetic/Orthotic Supplier | 2434 W Peterson Ave, Chicago, IL 60659-4113 | 2006-05-28 |
| 1447710421 | Scheck & Siress Prosthetics, Inc | Prosthetic/Orthotic Supplier | 2434 W Peterson Ave, Chicago, IL 60659-4113 | 2019-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1508410069 | Kara Lyn Anderson | Counselor | 2551 W. Peterson Ave, Chicago, IL 60659 | 2019-08-01 |
| 1568980019 | Saba Suleman | Counselor | 5815 N Spaulding Ave Apt 3a, Chicago, IL 60659 | 2017-09-05 |
| 1639695257 | Go Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 | 2017-08-15 |
| 1972039568 | Trilogy, Inc. | Community/Behavioral Health | 2551 W Peterson Ave, Chicago, IL 60659 | 2017-05-03 |
| 1689029050 | Soulu | Voluntary or Charitable | 3557 W Peterson Ave #122, Chicago, IL 60659 | 2016-05-04 |
| 1730540550 | Michael Wei-tsi Chien | Dentist | 3425 W Peterson Ave Ste 107, Chicago, IL 60659 | 2016-03-08 |
| 1497129688 | Acquaint Homecare LLC | Home Health | 3525 West Peterson Avenue, Unit 118, Chicago, IL 60659 | 2015-11-25 |
| 1083054621 | Rebecca Schnell | Speech-Language Pathologist | 6124 N Saint Louis Ave, Chicago, IL 60659 | 2013-06-27 |
| Find all providers in zip 60659 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831691104 | Ashley Zinnamon | Orthotist | 1525 E 55th St Ste 204, Chicago, IL 60615-5512 | 2018-03-02 |
| 1699896431 | Timothy W Porcelli | Orthotist | 3723 N Southport, Chicago, IL 60613-3718 | 2007-04-02 |
| 1306981345 | Matthew Alan Goddard | Orthotist | 2515 N Clark St Ste 802, Chicago, IL 60614-2730 | 2007-02-20 |
| 1386781755 | Andreas Josef Bohner | Orthotist | 2300 N Childrens Plz # 46, Chicago, IL 60614-3363 | 2007-02-01 |
| 1568509040 | Robert Allen Novak | Orthotist | 5521 N Cumberland Ave, Suite 1115, Chicago, IL 60656-4717 | 2007-01-31 |
| 1396371225 | Breanna Angela Baltrusch | Orthotist | 2515 N Clark St Ste 802, Chicago, IL 60614-2730 | 2020-03-23 |
| 1063062370 | Michael Socie | Orthotist | 355 E Erie St, Chicago, IL 60611-3167 | 2019-09-18 |
| 1679034177 | Sara L Jerousek | Orthotist | 225 E Chicago Ave, Chicago, IL 60611 | 2019-03-27 |
| 1083195424 | Erin Claussen | Orthotist | 225 E Chicago Ave # 46, Chicago, IL 60611-2991 | 2018-08-23 |
| 1215423843 | Sourabh Nagale | Orthotist | 2515 N Clark St, Ste 802, Chicago, IL 60614 | 2018-07-06 |
| Find all providers in CHICAGO | ||||
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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.