Organization Active NPI

Shifrin Group LLC

  • Ophthalmology Physician
  • Olympia Fields, IL
National Provider Identifier
1184904526
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036126041 Issued in IL
Legal business name
SHIFRIN GROUP LLC
Practice address
20303 Crawford Ave
LL1
Olympia Fields, IL 60461-1173
Phone
(312) 590-3572
Fax
(888) 716-0671
NPI assigned
Aug 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Dr. Kabita Sheila Shifrin, D.O.NPI 1700047222
Title
Physician
Phone
(312) 590-3572

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 036126041 IL Primary

Addresses

Primary practice location

20303 Crawford Ave
LL1
Olympia Fields, IL 60461-1173

Mailing address

20303 Crawford Ave
LL1
Olympia Fields, IL 60461-1173
Phone (312) 590-3572

Other identifiers 1

IdentifierTypeStateIssuer
8479629OtherILCIGNA

Other names 1

  • THE SHIFRIN GROUP, LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000607 IL Part B Supplier - Clinic/Group Practice 7618139338 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Frankfort, IL; Olympia Fields, IL; Tinley Park, IL

National Provider Directory

National Provider Directory

Locations

2335 S Michigan Ave
Chicago, IL 60616
Phone (312) 502-6200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1184904526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20303 CRAWFORD AVE",
            "address_2": "LL1",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611173",
            "telephone_number": "312-590-3572",
            "fax_number": "888-716-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20303 CRAWFORD AVE",
            "address_2": "LL1",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611173",
            "telephone_number": "312-590-3572",
            "fax_number": "888-716-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFRIN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "SHIFRIN",
        "authorized_official_first_name": "KABITA",
        "authorized_official_middle_name": "SHEILA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "312-590-3572",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036126041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8479629",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE SHIFRIN GROUP, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.