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MARY KIM D.M.D.
NPI 1184165516
Dentist - General Practice in Chicago, IL

Active since March 18, 2017PECOS Enrolled
2424 W PETERSON AVE, CHICAGO, IL 60659(773) 761-0300(773) 761-0300 Get Directions Write a Review

NPPES record last updated: March 1, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 1, 2022, Jan 31, 2022, May 11, 2021 and 3 more (6 updates tracked since 2017).

About Mary Kim D.m.d. NPPES

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

MARY KIM D.M.D. (NPI 1184165516) is an individual general practice provider in Chicago, Illinois, licensed in Georgia (DN122544) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1184165516
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameMARY KIMCredential: D.M.D.
Location Address2424 W PETERSON AVEChicago, IL 60659-4100
Mailing Address500 Prestwick LnWheeling, IL 60090-6231 · (847) 668-0125
Phone(773) 761-0300
Fax(773) 761-0300
Sole ProprietorNo
Enumeration DateMarch 18, 2017
Last NPPES UpdateMarch 1, 20226 updates tracked since enumeration
NPPES CertifiedMarch 1, 2022
✔ NPI 1184165516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in GA · DN122544
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedDentistTaxonomy 122300000X · License 019031189 (IL), 34965 (TX)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2424 W PETERSON AVE, Chicago, IL 60659
Open in Google Maps ↗

Secondary Practice Locations 4

Location 18800 Lockwood AveSkokie, IL 60077-1500 · Phone (773) 761-0300 · Fax (773) 761-0009
Location 22501 W Peterson AveChicago, IL 60659 · Phone (773) 761-0300 · Fax (773) 761-0009
Location 3251 E Huron StChicago, IL 60611-2908 · Phone (312) 926-2000
Location 48321 W Golf RdNiles, IL 60714-1113 · Phone (773) 761-0300 · Fax (773) 761-0009

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Kim D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60659 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASIAN HUMAN SERVICES, INC.
Community/Behavioral Health
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (708) 304-3586
ZITING XIAO
Counselor (Mental Health)
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (414) 552-9765
ASIAN HUMAN SERVICES, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (773) 761-0300
DR. NGOC-TUYEN THI PHI DDS
Dentist
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (773) 761-0300
NOUCHEE THAO
Counselor (Mental Health)
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (773) 564-4901
REBECCA KUYPERS
Counselor (Mental Health)
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (773) 761-0300
ASIAN HUMAN SERVICES, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (773) 293-8430
DR. ELIZABETH M.P. NGUYEN MD
Family Medicine
2424 W PETERSON AVE
CHICAGO, IL 60659
Cook County (773) 761-0300

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 Mary Kim's NPI number?

The NPI number for Mary Kim is 1184165516. It was assigned to this individual provider in the NPPES registry on March 18, 2017.

Where is Mary Kim located?

Mary Kim practices at 2424 W Peterson Ave, Chicago, IL 60659. The listed phone number is (773) 761-0300.

What is Mary Kim's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mary Kim enrolled in Medicare?

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

What insurance does Mary Kim accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness and Ambetter from Louisiana Healthcare Connections and 16 other insurers list Mary Kim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Kim was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.