Shaily Gaudani, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085009941 Issued in IL

Practice address

431 W Liberty St
Wauconda, IL 60084-2452

Phone

(847) 526-2151

NPI assigned

Feb 7, 2022

Last updated

Sep 21, 2023By the provider in NPPES

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

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Medicine Specialists of Mount Prospect S CGroup PAC ID 8224166566, 16 clinicians

Family Medicine Specialists of Round Lake Incorporated S CGroup PAC ID 6002957511, 20 clinicians

Family Medicine Specialists S.C.Group PAC ID 0042206252, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vista Medical Center East Hospital, Waukegan, IL, CCN 140084

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Medicine Specialists of Mount Prospect S C

  • Family Medicine Physician
  • Mount Prospect, IL
  • NPI 1437389475
  Medicare reassignment Care Compare group
• Family Medicine Specialists of Round Lake Incorporated S C

  • Family Medicine Physician
  • Round Lake Beach, IL
  • NPI 1740515253
  Medicare reassignment Care Compare group
• Family Medicine Specialists, S.C.

  • Family Medicine Physician
  • Wauconda, IL
  • NPI 1063406601
  Medicare reassignment Care Compare group

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

• Waukegan Illinois Hospital Company LLC

  dba Vista Medical Center East

  • General Acute Care Hospital
  • Waukegan, IL
  • NPI 1639120694
  Care Compare affiliation

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1174277305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6037",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600846037",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W LIBERTY ST",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842452",
            "telephone_number": "847-526-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDANI",
        "first_name": "SHAILY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Follmer and Podlasek Dentistry (Northwest Dental Health and Aesthetics)
• Dan Vincent Follmer, DDS
• Bonnie Frank
• Michele R Frese, APN
• Tabitha Jenell Gardner, APN
• Rachael A Gere, M.S. CCC-SLP
• Sujatha R Gogula, PA
• Carlos Gonzalez
• Eva Grimaldo, FNP-BC
• Nancy Grobarek, LCSW

• Physician Assistant in Wauconda, IL
• Providers in Wauconda, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.