JAE K KIM M.D.
NPI 1316981491
Anesthesiology in Canton, IL

Q: What is Jae Kim's NPI number?

The NPI number for Jae Kim is 1316981491. It was assigned to this individual provider in the NPPES registry on June 16, 2006.

Q: What is Jae Kim's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jae Kim was last updated on May 4, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since June 16, 2006PECOS Enrolled

210 W WALNUT ST, CANTON, IL 61520(309) 647-5240(309) 647-5104 Get Directions Write a Review

NPPES record last updated: May 4, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jae K Kim M.d. NPPES

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

JAE K KIM M.D. (NPI 1316981491) is an individual anesthesiology provider in Canton, Illinois, licensed in Illinois (036056328) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316981491

Entity TypeIndividualMale

Primary Taxonomy207L00000X

Provider Legal NameJAE K KIMCredential: M.D.

Location Address210 W WALNUT STCanton, IL 61520-2444

Mailing Address7309 N Knoxville Ave, Suite 200Peoria, IL 61614-2085 · (309) 691-6225 · Fax (309) 691-7635

Phone(309) 647-5240

Fax(309) 647-5104

Sole ProprietorYes

Enumeration DateJune 16, 2006

Last NPPES UpdateMay 4, 2015

✔ NPI 1316981491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians

Taxonomy Code207L00000X

License✔ Licensed in IL · 036056328

Definition

An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

210 W WALNUT ST, Canton, IL 61520

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Other Identifiers 5

Other320060699IL · Ein

Medicaid036056328IL

OtherP00945642IL · Railroad Medicare Ptan

Medicare PINIL2999IL

Medicare UPINC39993IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jae K Kim 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.

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Other Providers at the Same Location NPPES 20

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

DELLA EETEN CRNA

Nurse Anesthetist, Certified Registered