Jae Kim, M.D.
Jae Kim, M.D. is a healthcare organization registered as Anesthesiology Physician in Canton, IL, holding Type 2 (organization) NPI 1710928627 since 2006. The authorized official on file is Jae Kim, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1710928627 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Jae Kim, M.D. |
| Practice address | 210 W WALNUT ST, Canton, IL, 61520 |
| Phone | 3096475240 |
| Fax | 3096475104 |
| Enumeration date | 2006-06-10 |
| Last updated in NPPES | 2015-05-01 |
Authorized official
| Name | Jae Kim |
|---|---|
| Title | Owner |
| Phone | 3096718749 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207L00000X | Anesthesiology Physician | Primary | 036056328 | IL |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036056328 | Medicaid | IL | — |
| P00945642 | Other | IL | RAILROAD MEDICARE PTAN |
Copy-ready billing details
Provider: Jae Kim, M.D. NPI: 1710928627 Taxonomy: 207L00000X (Anesthesiology Physician) Address: 210 W WALNUT ST, Canton, IL, 61520
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1659365872 | Edrick Ferguson | Individual | Diagnostic Radiology Physician | Canton, IL |
| 1497723084 | Keith Ifft | Individual | Anesthesiology Physician | Canton, IL |
| 1932152402 | Muhammad Zaheer | Individual | Diagnostic Radiology Physician | Canton, IL |
| 1306884622 | Ronald Champagne | Individual | Anatomic Pathology & Clinical Pathology Physician | Canton, IL |
| 1316981491 | Jae Kim | Individual | Anesthesiology Physician | Canton, IL |
| 1972535607 | Canton Radiology Services, S.C. | Organization | Diagnostic Radiology Physician | Canton, IL |
| 1780692087 | Graham Hospital Association | Organization | Rural Acute Care Hospital | Canton, IL |
| 1376659029 | Graham Hospital Association | Organization | Institutional Pharmacy | Canton, IL |
Verify this record
Cross-check NPI 1710928627 against the authoritative CMS record: view Jae Kim, M.D. on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Jae Kim, M.D.?
What is the NPI number for Jae Kim, M.D.?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2015-05-01.