John Jay Shannon, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036079704 Issued in IL

Practice address

1900 W Polk St
Suite 220
Chicago, IL 60612-3723

Phone

(312) 864-5504

Fax

(312) 864-9994

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1104845734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "address_2": "SUITE 220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-5504",
            "fax_number": "312-864-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "address_2": "SUITE 220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-5504",
            "fax_number": "312-864-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JOHN",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036079704",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036079704",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036079704",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H2772",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "H2772",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "H2772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aisha A Shannon, LCSW
• Caleb Shannon
• Cara Shannon
• Corinne Shannon, PT
• Heather Shannon, LCPC
• Katherine Kerrigan Shannon, RN, MS
• Kathryn Shannon, PA-C
• Kristin Warner Shannon, APN-CNP
• Michael Francis Shannon, MD
• Robin Dana Shannon, LCPC

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.