FULLERTON KIMBALL MEDICAL & SURGICAL CENTER
NPI 1205964103
Clinic/Center - Ambulatory Surgical in Chicago, IL

Q: What is Fullerton Kimball Medical & Surgical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Active since March 01, 2007

3412 W FULLERTON AVE, CHICAGO, IL 60647(773) 235-8000 Get Directions Write a Review

NPPES record last updated: April 9, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Fullerton Kimball Medical & Surgical Center NPPES

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

FULLERTON KIMBALL MEDICAL & SURGICAL CENTER (NPI 1205964103) is a healthcare organization registered as an ambulatory surgical in Chicago, Illinois and active in the NPI registry since March 2007. The organization lists Renlin Xia, President, as its authorized official.

NPPES Registry Identity

NPI1205964103

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameFULLERTON KIMBALL MEDICAL & SURGICAL CENTER

Location Address3412 W FULLERTON AVEChicago, IL 60647-2416

Mailing Address3412 W Fullerton AveChicago, IL 60647-2416 · (773) 235-8000

Phone(773) 235-8000

Organization SubpartNo

Authorized OfficialRenlin XiaPresident · (773) 235-8000

Enumeration DateMarch 1, 2007

Last NPPES UpdateApril 9, 2014

✔ NPI 1205964103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

License✔ Licensed in IL · 7003181

3412 W FULLERTON AVE, Chicago, IL 60647

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Other Identifiers 2

Other261Q00000XIL · Taxonomy Code

Medicare ID-Type Unspecified141064IL

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fullerton Kimball Medical & Surgical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Fullerton Kimball Medical & Surgical Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Renlin Xia, MD

General Practice

NPI 1790809960

3412 W FULLERTON AVE
Chicago, IL 60647

(773) 235-8000

✔ PECOSSame address

Tian Xia, DO

Anesthesiology

NPI 1467492728

244 E. ROOSEVELT RD.
Lombard, IL 60148

(630) 629-6298

✔ PECOS✔ Accepts Medicare16 mi

Sheel Patel, M.D.

Anesthesiology

NPI 1558657346

3630 WILLOWCREEK RD STE 9
Portage, IN 46368

(219) 364-3700

✔ PECOS✔ Accepts Medicare38 mi

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

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

87 services35 patients

Insertion of spinal neurostimulator electrode array through skin 63650

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

52 services19 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

46 services20 patients

Insertion or replacement of spinal neurostimulator generator or receiver 63685

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

16 services16 patients

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 Fullerton Kimball Medical & Surgical Center's NPI number?

The NPI number for Fullerton Kimball Medical & Surgical Center is 1205964103. It was assigned to this organization in the NPPES registry on March 1, 2007.

Where is Fullerton Kimball Medical & Surgical Center located?

Fullerton Kimball Medical & Surgical Center is located at 3412 W Fullerton Ave, Chicago, IL 60647. The listed phone number is (773) 235-8000.

What is Fullerton Kimball Medical & Surgical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Fullerton Kimball Medical & Surgical Center enrolled in Medicare?

Yes. Fullerton Kimball Medical & Surgical Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fullerton Kimball Medical & Surgical Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Fullerton Kimball Medical & Surgical Center, in Anesthesiology and General Practice. A 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 the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Fullerton Kimball Medical & Surgical Center was last updated on April 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.