Individual provider Active NPI

Semyon Shulman

  • Neurology Physician
  • North Chicago, IL
National Provider Identifier
1003820333
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Practice address
3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone
(847) 688-1900
Fax
(847) 610-2940
NPI assigned
Jul 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X IL Primary

Addresses

Primary practice location

3001 Green Bay Rd
North Chicago, IL 60064-3048

Mailing address

144 Southfield Dr
Vernon Hills, IL 60061-3208
Phone (847) 362-4656

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130601000096 IL Order and Referring Only - NeurologyPractitioner - Neurology 1850539982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036-091762ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurowisconsin SC Neurology Past Accepting new patients

Organizations & group practices 1

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003820333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 SOUTHFIELD DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600613208",
            "telephone_number": "847-362-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "847-688-1900",
            "fax_number": "847-610-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "SEMYON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.