Healthcare Provider Details

I. General information

NPI: 1528868759
Provider Name (Legal Business Name): DEFINED KJ INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 LAKEVIEW PKWY UNIT 101, SUITE #9
VERNON HILLS IL
60061
US

IV. Provider business mailing address

935 LAKEVIEW PKWY STE 101
VERNON HILLS IL
60061-1443
US

V. Phone/Fax

Practice location:
  • Phone: 414-202-3249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. JIMMY NINH
Title or Position: PRESIDENT
Credential: MD
Phone: 847-916-7255