Individual provider Active NPI

Shreya Kanabar, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1023498029
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125067156 Issued in IL
Practice address
1645 W Jackson Blvd
Chicago, IL 60612-3276
Phone
(312) 942-2200
NPI assigned
Jun 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125067156 IL Primary

Addresses

Primary practice location

1645 W Jackson Blvd
Chicago, IL 60612-3276

Mailing address

1650 W Harrison St
Suite 466 Atrium
Chicago, IL 60612-3800

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
I20160630000838 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1759673304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125067156ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children's Hospital of Chicago Current Accepting new patients
Pediatric Health Associates LTD Pediatrics Past Accepting new patients
Dupage Medical Group LTD Past Accepting new patients
University of Chicago Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: skanabar251722@direct.luriechildrens.org

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1023498029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W HARRISON ST",
            "address_2": "SUITE 466 ATRIUM",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123276",
            "telephone_number": "312-942-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANABAR",
        "first_name": "SHREYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125067156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.