DR. JUN DONG KIM (DO) – Obstetrics & Gynecology Physician, NPI 1336411610
Obstetrics & Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,923 OBSTETRICS/GYNECOLOGY in IL
Provider Addresses for DR. JUN DONG KIM (DO)
1490 E Walnut St Ste A
Watseka, IL 609701806
Phone: (815) 432-7693
Fax: (815) 936-7228
Type: Location
338 Larry Power Rd
Bourbonnais, IL 609144430
Phone: (815) 935-4651
Fax: (815) 935-2970
Type: Location
100 W CHICAGO AVE STE F
EAST CHICAGO, IN 463123261
Phone: (219) 392-7016
Fax: (219) 397-6904
Type: Location
338 LARRY POWER RD
BOURBONNAIS, IL 609144430
Phone: (815) 935-4651
Fax: (815) 935-2970
Type: Mailing
400 N Wall St Ste B405
Kankakee, IL 609012940
Phone: (815) 935-4651
Fax: (815) 935-2970
Type: Location
3432 169th St
Hammond, IN 463232542
Phone: (219) 844-9060
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $229.
Total Amount is formed as General ($229) + Research ($0) + Ownership ($0) = $229.
Last reported payment date: 2024-08-13 • Largest payer in this snapshot: ABBVIE INC. ($71).
Total Amount
$229
General + Research + Ownership
Payments
11
Total payment records
General Amount
$229
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $71 |
| Axsome Therapeutics, Inc. | $31 |
| Corium, LLC | $26 |
| Exeltis, USA Inc. | $19 |
| Indivior Inc. | $19 |
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: 2019-07-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190724000709 | I | Obstetrics/Gynecology | IN | TBD |
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.
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 60970)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| E N D O C R I N O L O G Y | IN | |
| - | IL | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | KY | |
| Internal Medicine | IN | |
| Internal Medicine | IN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL | |
| Internal Medicine | IL |
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