Individual provider Active NPI

Shahira Halim

  • Nurse Practitioner
  • Chicago Ridge, IL
National Provider Identifier
1124796941
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.023973 Issued in IL
Practice address
10604 Southwest Hwy Ste 200
Chicago Ridge, IL 60415-2717
Phone
(708) 424-9710
NPI assigned
Sep 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.023973 IL Primary

Addresses

Primary practice location

10604 Southwest Hwy Ste 200
Chicago Ridge, IL 60415-2717

Mailing address

16411 Manchester St
Tinley Park, IL 60477-2511

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220822003139 IL Practitioner - Nurse Practitioner 1355724485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Pulmonary Critical Care and Sleep Consultants LLCGroup PAC ID 5799048526, 31 clinicians

Practice addresses (Care Compare)

10604 Southwest Hwy
Suite 107
Chicago Ridge, IL 60415-2717
Phone (708) 422-0636

12820 S Ridgeland Ave
Suite B
Palos Heights, IL 60463-2389
Phone (708) 371-8006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.023973ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Oncologists, LLC CurrentSince Sep 12, 2021 Accepting new patients
Midwest Pulmonary Critical Care & Sleep Consultants LLC CurrentSince May 10, 2022 Accepting new patients
Pulmonary Consultants, SC PastSince Sep 1, 2004 Accepting new patients

Locations

29777 Network Pl
Chicago, IL 60673

10604 Southwest Hwy
Ste 200
Chicago Ridge, IL 60415
Phone (708) 634-4644

12820 S Ridgeland Ave
Ste B
Palos Heights, IL 60463
Phone (708) 371-8006

Organizations & group practices 3

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": "1630886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1124796941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16411 MANCHESTER ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 SOUTHWEST HWY STE 200",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152717",
            "telephone_number": "708-424-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALIM",
        "first_name": "SHAHIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-06",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.023973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

Verify at the official NPI Registry.