Ruth Shannon

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178016335 Issued in IL

Practice address

7616 S Merrill Ave
Chicago, IL 60649-4133

Phone

(312) 459-1372

Fax

(866) 808-3495

NPI assigned

Aug 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1164196994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7616 S MERRILL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606494133",
            "telephone_number": "312-459-1372",
            "fax_number": "866-808-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7616 S MERRILL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606494133",
            "telephone_number": "312-459-1372",
            "fax_number": "866-808-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "RUTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178016335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ruth@ahavasoul.com",
            "affiliation": "N",
            "endpointDescription": "This is the sole proprietor email address that will be used to share HIPAA protected PHI",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "7616 S Merrill Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606494133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Kerrigan Shannon, RN, MS
• Kathryn Shannon, PA-C
• Kristin Warner Shannon, APN-CNP
• Michael Francis Shannon, MD
• Robin Dana Shannon, LCPC
• Ismaeel Shanshal
• Carolbeth Shansky, PHD
• Daniel Shansky
• Shantharaj Samuel M.D.,S.C.
• Daming Shao

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.