Individual provider Active NPI

Shan Guleria, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1003438813
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.164206 Issued in IL
Practice address
5841 S Maryland Ave Ste
MC 6076
Chicago, IL 60637-1626
Phone
(773) 834-3500
NPI assigned
May 14, 2020
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125075662 IL
Internal Medicine Physician 207R00000X 036.164206 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave Ste
MC 6076
Chicago, IL 60637-1626

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230627002346 IL Practitioner - Hospitalist 4981029279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.164206ILMDInternal Medicine Physician
125075662ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
University of Chicago Medical Center PastSince May 12, 2024 Accepting new patients

Locations

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1003438813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE STE",
            "address_2": "MC 6076",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371626",
            "telephone_number": "773-834-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULERIA",
        "first_name": "SHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125075662",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.164206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.