Individual provider Active NPI

Stewart Aaron Shankman, PH.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1114106697
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
1007 W Harrison St RM 1062D
M/C 285
Chicago, IL 60607-7135
Phone
(312) 355-3812
Fax
(312) 413-4122
NPI assigned
Oct 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X IL
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

1007 W Harrison St RM 1062D
M/C 285
Chicago, IL 60607-7135

Mailing address

1007 W Harrison St RM 1062D
M/C 285
Chicago, IL 60607-7135
Phone (312) 355-3812

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1114106697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 W HARRISON ST RM 1062D",
            "address_2": "M/C 285",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606077135",
            "telephone_number": "312-355-3812",
            "fax_number": "312-413-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 W HARRISON ST RM 1062D",
            "address_2": "M/C 285",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606077135",
            "telephone_number": "312-355-3812",
            "fax_number": "312-413-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKMAN",
        "first_name": "STEWART",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.