SE YUN KIM (LCSW) – Clinical Social Worker, NPI 1205553021

SE YUN KIM (LCSW) is a healthcare provider. based in Chicago, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 149.027266 (IL). The NPI Number for SE YUN KIM (LCSW) is 1205553021

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
SE YUN KIM (LCSW)
NPI
1205553021
Phone
Not provided
Address
1 E ERIE ST STE 525
Enumeration Date
24 October 2022
Last Update Date
26 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Secondary Phone
8473774650
Graduation Year
2022 (4 years ago)
PAC ID
1850757840
Group Practice PAC ID
7214838861
Professional Enrollment ID
I20230517002002
Address ID
IL600852321WA3010XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for SE YUN KIM (LCSW)

  • 1 E ERIE ST STE 525

    #413

    CHICAGO, IL 60611

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230517002002IClinical Social WorkerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60611)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214838861View full group profile
NameSpecialtyState
Nurse PractitionerIL
-IL
P S Y C H I A T R YIL
-IL
Nurse PractitionerFL
Family PracticeIL
Internal MedicineIL
Family PracticeIL
Mental Health CounselorIL
-WI

Reviews

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Frequently asked questions

Where can patients find SE YUN KIM (LCSW)'s NPI?
You can confirm SE YUN KIM (LCSW) with NPI 1205553021; it appears in the national provider directory.
Is SE YUN KIM (LCSW) active in the national directory?
SE YUN KIM (LCSW)'s public NPI profile is in an active state.
What field does SE YUN KIM (LCSW) work in?
You can think of SE YUN KIM (LCSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place SE YUN KIM (LCSW)?
The snapshot lists Chicago, Illinois for SE YUN KIM (LCSW); download NPPES for the complete set.
Is SE YUN KIM (LCSW) a real provider?
This page reflects official NPPES data for NPI 1205553021. Always confirm identity and privileges with the practice and licensing boards.

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