Active NPI
Andrew Shadel, ATC
- Athletic Trainer
- Chicago Heights, IL
National Provider Identifier
1023424595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 100 197TH PL
Chicago Heights, IL 60411-7539 - Phone
- (708) 755-3020
- NPI assigned
- Jul 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
100 197TH PL
Chicago Heights, IL 60411-7539
Mailing address
3313 Shadowood Dr
Crystal Lake, IL 60012-1337
Phone (815) 353-7736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1023424595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3313 SHADOWOOD DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600121337",
"telephone_number": "815-353-7736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 197TH PL",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604117539",
"telephone_number": "708-755-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADEL",
"first_name": "ANDREW",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-06",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.