Provider Demographics
NPI:1679527998
Name:KINN, JAMES WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:KINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD STE 500
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-232-2800
Mailing Address - Fax:630-933-3626
Practice Address - Street 1:25 NORTH WINFIELD ROAD
Practice Address - Street 2:NORTH ENTRANCE
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-510-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093128207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCA4748OtherMEDICARE RAILROAD (GROUP)
ILP01345532OtherMEDICARE RAILROAD (INDIVIDUAL)
ILF400139324OtherMEDICARE PTAN (INDIVIDUAL)
IL036093128Medicaid
IL206147OtherMEDICARE PTAN (GROUP)
ILF400139324OtherMEDICARE PTAN (INDIVIDUAL)