PETER KIM (NPI# 1750902003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750902003 |
| Entity Type | Individual |
| Full Name | PETER KIM |
| Credential | MD |
| Practice Address |
3249 Oak Park Ave Berwyn IL 60402-0715 |
| Mailing Address |
1411 N Bosworth Ave Apt 2 Chicago IL 60642-2494 |
| Practice Telephone | 7087839100 |
| Mailing Telephone | 6307407298 |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2020-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 125.076158 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295298891 | Peter Y Kim | Specialist | 1380 Howard St # 201c, San Francisco, CA 94103-2638 | 2019-04-10 |
| 1922518208 | Peter Kim | Dentist | 15737 E Prentice Dr, Centennial, CO 80015-4264 | 2017-10-02 |
| 1336593391 | Peter Eugene Kim | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Radiology, Albany, NY 12208 | 2016-04-15 |
| 1821475369 | Peter Eusuk Kim | Dentist | 4649 Loma Del Sur Dr, Apt 3307, El Paso, TX 79934-3350 | 2015-05-05 |
| 1497041438 | Peter P Kim | Orthotic Fitter | 720 S. Ramona Ave., Suite 103, Corona, CA 92879-2147 | 2011-06-28 |
| 1184915761 | Peter Hwa Kim | Acupuncturist | 801 N Tustin Ave Ste 501, Santa Ana, CA 92705-3609 | 2011-04-29 |
| 1821257528 | Peter Simon Kim | Podiatrist | 5220 Pacific Concourse Dr, Ste 120, Los Angeles, CA 90045-6244 | 2008-06-06 |
| 1164603965 | Peter Yeon-seong Kim | Internal Medicine | 1400 Pressler, Suite Fct 11.5012, Md Anderson Cancer - Pickens Academic Tower, Houston, TX 77030 | 2007-11-20 |
| 1972725844 | Peter M Kim | Dentist | 2415 G St, Bakersfield, CA 93301-2809 | 2007-05-02 |
| 1053454983 | Peter Sang Kim | Acupuncturist | 929 N Western Ave, Los Angeles, CA 90029-3215 | 2007-02-14 |
| Street Address |
3249 OAK PARK AVE |
| City | BERWYN |
| State | IL |
| Zip Code | 60402-0715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982690830 | Mark Choi | Radiology | 3249 Oak Park Ave, Metropolitan Advanced Radiological Services, Ltd, Berwyn, IL 60402-3429 | 2005-09-26 |
| 1316553969 | Bridget Prendergast | Nurse Anesthetist, Certified Registered | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-09-18 |
| 1033731914 | Nicolas Zuniga Penaranda | Student in an Organized Health Care Education/Training Program | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-05-13 |
| 1508487786 | Jack Steven Schirmer | Family Medicine | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-04-29 |
| 1851911762 | Tucker Brush | Internal Medicine | 3249 Oak Park Ave, Berwyn, IL 60402-0715 | 2020-04-21 |
| 1225657497 | Yesenia Valdivia | Student in an Organized Health Care Education/Training Program | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-04-08 |
| 1386273621 | Darryl Jon Giambalvo | Student in an Organized Health Care Education/Training Program | 3249 Oak Park Ave, Berwyn, IL 60402-0715 | 2020-04-08 |
| 1700415049 | Brett Patrick Nelson | Family Medicine | 3249 Oak Park Ave, Berwyn, IL 60402-0715 | 2020-04-08 |
| 1013546753 | Maria Ramirez | Family Medicine | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-04-04 |
| 1154959435 | Kavita Pravin Patel | Family Medicine | 3249 Oak Park Ave, Berwyn, IL 60402-3429 | 2020-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760910962 | Acosta and Cabrera Medical Associates, S.c. | Family Medicine | 3100 Oak Park Ave Ste 1s, Berwyn, IL 60402-4177 | 2017-06-01 |
| 1780006619 | Villasenor In-home Patient Care LLC | Family Medicine | 1639 Oak Park Ave, Berwyn, IL 60402-1782 | 2014-01-12 |
| 1881031656 | Stephanie S Kim | Family Medicine | 3231 S. Euclid Avenue, 5th Floor, Berwyn, IL 60402 | 2013-06-03 |
| 1851644942 | Lose Weight 1 LLC | Family Medicine | 901 Lancaster Ave, Suite 100, Berwyn, PA 19312-1710 | 2012-10-26 |
| 1548550262 | Mayra Gonzalez | Family Medicine | 7000 West Cermak Road, Berwyn, IL 60402 | 2011-04-14 |
| 1356586853 | Susan Marie Kennedy | Family Medicine | 1185 S Leopard Rd, Berwyn, PA 19312-2028 | 2008-12-11 |
| 1306090212 | Perez Health, Incorporated | Family Medicine | 6842 W. Cermak Road, Berwyn, IL 60402-2240 | 2008-11-06 |
| 1265690523 | Aaron D Lee | Family Medicine | 3231 S Euclid Ave, 5th Floor, Berwyn, IL 60402 | 2008-05-23 |
| 1265623540 | Charito M Delatorre | Family Medicine | 1909 Clinton Ave, Berwyn, IL 60402-1642 | 2007-08-05 |
| 1801003991 | Edgar E Archbold | Family Medicine | 6917 W Cermak Rd, Berwyn, IL 60408 | 2007-05-17 |
| Find all providers in BERWYN | ||||
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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.