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FULLERTON KIMBALL MEDICAL GROUP SC
NPI 1831213081
Clinic/Center - Multi-Specialty in Chicago, IL

Active since March 16, 2007
3412 W FULLERTON AVE, CHICAGO, IL 60647(773) 235-8000 Get Directions Write a Review

NPPES record last updated: August 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 24, 2023, Jul 21, 2022 (2 updates tracked since 2022).

About Fullerton Kimball Medical Group Sc NPPES

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

FULLERTON KIMBALL MEDICAL GROUP SC (NPI 1831213081) is a healthcare organization registered as a multi-specialty 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

NPI1831213081
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameFULLERTON KIMBALL MEDICAL GROUP SC
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 16, 2007
Last NPPES UpdateAugust 24, 20232 updates tracked since enumeration
NPPES CertifiedMarch 22, 2021
✔ NPI 1831213081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
3412 W FULLERTON AVE, Chicago, IL 60647
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Other Identifiers 2

Other01635426IL · Bcbs Group
Medicaid036088691 4IL

Other Providers at the Same Location NPPES 8

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

FULLERTON KIMBALL MEDICAL & SURGICAL CENTER
Clinic/Center (Ambulatory Surgical)
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000
DR. GREGORY WELLS M.D.
Anesthesiology
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000
RENLIN XIA MD
Pain Medicine (Pain Medicine)
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000
CMP PROFESSIONAL SERVICES
Pain Medicine (Pain Medicine)
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000
MIGUEL CUA MD
Anesthesiology
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000
KUMAR ANESTHESIA PAIN ASSOCIATES, INC
Anesthesiology (Pain Medicine)
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (347) 927-4037
INTEGRATED PAIN MANAGEMENT SC
Anesthesiology (Pain Medicine)
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000
LIAUW DEVI GUNAWAN NURSE PRACTITIONER
Nurse Practitioner (Family)
3412 W FULLERTON AVE
CHICAGO, IL 60647
Cook County (773) 235-8000

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 Group Sc's NPI number?

The NPI number for Fullerton Kimball Medical Group Sc is 1831213081. It was assigned to this organization in the NPPES registry on March 16, 2007.

Where is Fullerton Kimball Medical Group Sc located?

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

What is Fullerton Kimball Medical Group Sc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Fullerton Kimball Medical Group Sc was last updated on August 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.