Shelbie Waddle, DO, MS, MS

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

125.084651 Issued in IL

Practice address

420 E Superior St Ste 9-900
Chicago, IL 60611-4494

Phone

(312) 503-7975

NPI assigned

May 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Master of Science

State licenses

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

{
    "created_epoch": "1589068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1023630399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST STE 9-900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST STE 9-900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 S Rainbow Blvd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891181859",
            "country_code": "US",
            "telephone_number": "702-853-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011990001",
            "country_code": "US",
            "telephone_number": "413-794-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADDLE",
        "first_name": "SHELBIE",
        "name_prefix": "Dr.",
        "credential": "DO, MS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-10",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.084651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Ann Waddell, MAOL
• Donald Waddell, PHARMD
• Kimberly Waddell, OTR/L
• Torri Waddell
• Mandy Waddick, MS CCC SLP
• Annelise Nicole Waddoups, MD
• Wade Wellness, Inc.
• Andrew Wade, MB, BCH, BAO
• Arquette C Wade, MMS, PA-C
• Billy Wade Jr., L.C.S.W

• Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.