Shelly L. Betman, M.D. S.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36081638 Issued in IL

Legal business name

SHELLY L. BETMAN, M.D. S.C.

Practice address

676 N Saint Clair St Ste 1525
Chicago, IL 60611-2862

Phone

(312) 926-3470

Fax

(312) 926-3483

NPI assigned

Dec 17, 2007

Organization subpart

No

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

Authorized official

Name

Shelly L Betman, MDNPI 1114064672

Title

President

Phone

(440) 279-0599

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Shelly L Betman, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1114064672
  Medicare reassignment Authorized official
• Jane M Vogelmann, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1588740724
  NPD (past)

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499299200000",
    "number": "1194908822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N. SAINT CLAIR",
            "address_2": "SUITE 1525",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113197",
            "telephone_number": "312-926-3470",
            "fax_number": "312-926-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 1525",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112862",
            "telephone_number": "312-926-3470",
            "fax_number": "312-926-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLY L. BETMAN, M.D. S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2017-07-06",
        "status": "A",
        "authorized_official_last_name": "BETMAN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-279-0599",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36081638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081638",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheldon S. Greenberg, M.D., S.C.
• Brooke Sheldon
• Nicole J Sheldon, L.AC.
• Stephen Howard Sheldon, DO
• Kelley Lynne Shellenberger, APRN, CNP
• Tyheatsha Shelly
• Qiana Nakea Shelton-Simpson, D.T.
• Alexis Shelton
• Dequita Shelton, CADC
• Erin Shelton, PT

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; 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.