Active NPI
Geoffrey Sydney Shaw, MD
- Psychiatry Physician
- Northfield, IL
National Provider Identifier
1184730053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Practice address
- 191 Waukegan Rd
Ste 120
Northfield, IL 60093 - Phone
- (847) 716-1302
- Fax
- (847) 716-1312
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
191 Waukegan Rd
Ste 120
Northfield, IL 60093
Mailing address
191 Waukegan Rd
Ste 120
Northfield, IL 60093
Phone (847) 716-1302
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051104000232 | IL | Practitioner - Psychiatry | 8527086982 | Practice locations: Northfield, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
550 W Frontage Rd
Suite 2745
Northfield, IL 60093-1260
Phone (847) 716-1302
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184730053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "191 WAUKEGAN RD",
"address_2": "STE 120",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "60093",
"telephone_number": "847-716-1302",
"fax_number": "847-716-1312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 WAUKEGAN RD",
"address_2": "STE 120",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "60093",
"telephone_number": "847-716-1302",
"fax_number": "847-716-1312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "GEOFFREY",
"middle_name": "SYDNEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.