FULLERTON KIMBALL MEDICAL & SURGICAL CENTER
NPI 1205964103
Clinic/Center - Ambulatory Surgical in Chicago, IL
NPI Status: Active since March 01, 2007
Contact Information
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
Phone: (773) 235-8000
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
About FULLERTON KIMBALL MEDICAL & SURGICAL CENTER
This page provides the complete NPI Profile along with additional information for Fullerton Kimball Medical & Surgical Center, a provider established in Chicago, Illinois operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1205964103 assigned on March 2007. The practitioner's primary taxonomy code is 261QA1903X with license number 7003181 (IL). The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Dr. Renlin Xia M.d (President)
- NPI
- 1205964103
- Provider Name
- FULLERTON KIMBALL MEDICAL & SURGICAL CENTER
- Entity Type
- Organization
- Location Address
- 3412 W FULLERTON AVE CHICAGO, IL 60647
- Location Phone
- (773) 235-8000
- Mailing Address
- 3412 W FULLERTON AVE CHICAGO, IL 60647
- Mailing Phone
- (773) 235-8000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-01-2007
- Last Update Date
- 04-09-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
- License No.
- 7003181
- License State
- IL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
- Blue Precision Bronze HMO? 205 - HMO
- Blue Precision Bronze HMO? 701 - HMO
- Blue Precision Bronze HMO? Standard - Select Rx Copays - HMO
- Blue Precision Gold HMO? 207 - HMO
- Blue Precision Gold HMO? 703 - HMO
- Blue Precision Gold HMO? Standard - Rx Copays - HMO
- Blue Precision Silver HMO? 206 - HMO
- Blue Precision Silver HMO? 704 - HMO
- Blue Precision Silver HMO? Standard - Select Rx Copays - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 261Q00000X | OTHER (01) | IL | TAXONOMY CODE |
| 141064 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL |
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
Injection of lower or sacral spine facet joint using imaging guidance, single level
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
Insertion of spinal neurostimulator electrode array through skin
Insertion of spinal neurostimulator generator or receiver
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.
This service was performed 127 times for 49 patientsThis procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
This service was performed 34 times for 12 patientsThis 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.
This service was performed 42 times for 15 patientsThis 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.
This service was performed 71 times for 26 patientsThe 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.
This service was performed 18 times for 18 patientsReviews for FULLERTON KIMBALL MEDICAL & SURGICAL CENTER
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 0 | 5 | 9 | 6 | 4 | 1 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 0 | 5 | 18 | 6 | 8 | 1 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 0 + 5 + 1 + 8 + 6 + 8 + 1 + 0 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1205964103 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
RENLIN XIA MD
Pain Medicine
(Pain Medicine)
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
MIGUEL CUA MD
Anesthesiology
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
DR. GREGORY WELLS M.D.
Anesthesiology
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
INTEGRATED PAIN MANAGEMENT SC
Anesthesiology
(Pain Medicine)
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
LIAUW DEVI GUNAWAN NURSE PRACTITIONER
Nurse Practitioner
(Family)
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
CMP PROFESSIONAL SERVICES
Anesthesiology
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
FULLERTON KIMBALL MEDICAL GROUP SC
Clinic/Center
(Multi-Specialty)
3412 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205964103, enumerated as an "organization" on March 01, 2007.
The provider is located at 3412 W FULLERTON AVE CHICAGO, IL 60647 and the phone number is (773) 235-8000.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to verify.
