RAY S KIM PHD
NPI 1912906116
Psychologist in Crystal Lake, IL

Active since July 19, 2005PECOS EnrolledAccepts Medicare Assignment
500 COVENTRY LN, SUITE 205, CRYSTAL LAKE, IL 60014(815) 455-7100(815) 455-3951 Get Directions Write a Review

NPPES record last updated: July 5, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ray S Kim Phd NPPES

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

RAY S KIM PHD (NPI 1912906116) is an individual psychologist in Crystal Lake, Illinois, licensed in Illinois (071-005373) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1912906116
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameRAY S KIMCredential: PHD
Location Address500 COVENTRY LN, SUITE 205Crystal Lake, IL 60014-7579
Mailing Address500 Coventry Ln, Suite 205Crystal Lake, IL 60014-7579 · (815) 455-7100 · Fax (815) 455-3951
Fax(815) 455-3951
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateJuly 19, 2005
Last NPPES UpdateJuly 5, 2012
NPI 1912906116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in IL · 071-005373
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
500 COVENTRY LN, Crystal Lake, IL 60014

Other Identifiers 2

Other05619771IL · Bcbs
Medicare ID-Type Unspecified590350IL

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ray S Kim Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941334361
PECOS Enrollment IDI20100819001060
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.

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.

Psychologist
500 COVENTRY LN, SUITE 170
CRYSTAL LAKE, IL 60014
Occupational Therapist
500 COVENTRY LN
CRYSTAL LAKE, IL 60014
Counselor (Professional)
500 COVENTRY LN, SUITE 205
CRYSTAL LAKE, IL 60014
Marriage & Family Therapist
500 COVENTRY LN, SUITE 205
CRYSTAL LAKE, IL 60014
Nurse Practitioner
500 COVENTRY LN
CRYSTAL LAKE, IL 60014
Psychiatry & Neurology (Neurology)
500 COVENTRY LN
CRYSTAL LAKE, IL 60014
Psychiatry & Neurology (Child & Adolescent Psychiatry)
500 COVENTRY LN, SUITE 205
CRYSTAL LAKE, IL 60014
Speech-Language Pathologist
500 COVENTRY LN, SUITE 170
CRYSTAL LAKE, IL 60014

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 Ray Kim's NPI number?

The NPI number for Ray Kim is 1912906116. It was assigned to this individual provider in the NPPES registry on July 19, 2005.

Where is Ray Kim located?

Ray Kim practices at 500 Coventry Ln Suite 205, Crystal Lake, IL 60014. The listed phone number is (815) 455-7100.

What is Ray Kim's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Ray Kim enrolled in Medicare?

Yes. Ray Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ray Kim accept?

Health plans from Providence Health Plan list Ray 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 Ray Kim was last updated on July 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.