Individual provider Active NPI

Shannon Xiang Li, MD

  • Cardiovascular Disease Physician
  • Oak Park, IL
National Provider Identifier
1164957064
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036152071 Issued in IL
Practice address
610 S Maple Ave Ste 5500
Oak Park, IL 60304-2808
Phone
(708) 383-9300
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036152071 IL
Cardiovascular Disease Physician 207RC0000X 036.152071 IL
Cardiovascular Disease Physician 207RC0000X 036152071 IL Primary

Addresses

Primary practice location

610 S Maple Ave Ste 5500
Oak Park, IL 60304-2808

Mailing address

610 S Maple Ave Ste 5500
Oak Park, IL 60304-2808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230731002593 IL Practitioner - Cardiovascular Disease (Cardiology) 0446520605 Reassigns benefits to 1 organization
I20231101001853 IN Practitioner - Cardiovascular Disease (Cardiology) 0446520605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Vermont College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

610 S Maple Ave
Suite 5500
Oak Park, IL 60304-2808
Phone (708) 660-5777

9200 Calumet Ave
Suite E107
Munster, IN 46321-2885
Phone (219) 806-6585

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036152071ILMDInternal Medicine Physician
036.152071ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1625 N Harlem Ave
Chicago, IL 60707
Phone (312) 256-8583

1725 W Harrison St
Ste 1159
Chicago, IL 60612
Phone (312) 942-5020

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1411 S Michigan Ave
Chicago, IL 60605
Phone (312) 454-2700

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

9200 Calumet Ave
Ste E107
Munster, IN 46321
Phone (219) 806-6585

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1164957064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE STE 5500",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603042808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE STE 5500",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603042808",
            "telephone_number": "708-383-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "SHANNON",
        "middle_name": "XIANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036152071",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.152071",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036152071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.