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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JISOO KIM
NPI 1144924259
Family Medicine in Algonquin, IL

Active since March 30, 2023PECOS Enrolled
1345 RYAN PKWY STE 2140, ALGONQUIN, IL 60102(847) 658-9555 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 24, 2026, Jun 2, 2023, Mar 30, 2023 (3 updates tracked since 2023).

About Jisoo Kim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JISOO KIM (NPI 1144924259) is an individual family medicine provider in Algonquin, Illinois, licensed in Illinois (036.178291) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Berwyn, and is a graduate of Midwestern University, Chicago College Of Osteopathic Med (2023).

NPPES Registry Identity

NPI1144924259
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameJISOO KIM
Location Address1345 RYAN PKWY STE 2140Algonquin, IL 60102-4530
Mailing Address29373 Network PlChicago, IL 60673-1293 · (847) 390-5900
Phone(847) 658-9555
Sole ProprietorNo
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 2023
Enumeration DateMarch 30, 2023
Last NPPES UpdateSeptember 24, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2026
✔ NPI 1144924259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036.178291
Definition
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.
1345 RYAN PKWY STE 2140, Algonquin, IL 60102
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Secondary Practice Location 1

Location 13249 Oak Park AveBerwyn, IL 60402-3429 · Phone (877) 834-7264

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jisoo Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840649711
PECOS Enrollment IDI20260828002680
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jisoo Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lutheran General Hospital
23 mi
Cardiovascular Disease
1775 DEMPSTER ST
Park Ridge, IL 60068
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Advocate Health And Hospitals Corporation
  • 4,870 clinicians in this Medicare group
NPI 1801809306 (847) 723-2210

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jisoo Kim's NPI number?

The NPI number for Jisoo Kim is 1144924259. It was assigned to this individual provider in the NPPES registry on March 30, 2023.

Where is Jisoo Kim located?

Jisoo Kim practices at 1345 Ryan Pkwy Ste 2140, Algonquin, IL 60102. The listed phone number is (847) 658-9555.

What is Jisoo Kim's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jisoo Kim enrolled in Medicare?

Yes. Jisoo Kim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jisoo Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jisoo Kim reassigns Medicare benefits to Lutheran General Hospital (Park Ridge, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jisoo Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jisoo Kim was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.