Individual provider Active NPI

Shannon Marie Glynn, MD

  • Gynecologic Oncology Physician
  • Chicago, IL
National Provider Identifier
1134705122
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
036.174201 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(410) 955-5000
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 036.174201 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

600 N Wolfe St
Baltimore, MD 21287-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210607000487 MD Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 1658771043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.174201ILMDGynecologic Oncology Physician

Interoperability endpoints

  • Direct secure messaging: shannon.glynn.p1@direct.bmsi.nextgenshare.com
  • Direct secure messaging: sglynn57878@gbmcdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1134705122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IL",
            "license": "036.174201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.