Individual provider Active NPI

Michelle Renee Shimek, ACNP, CNP

  • Nurse Practitioner
  • McHenry, IL
National Provider Identifier
1205665478
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209030245 Issued in IL
Practice address
4309 W Medical Center Dr Ste A200
McHenry, IL 60050-8437
Phone
(815) 759-8180
Fax
(815) 759-4931
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209030245 IL Primary
Acute Care Nurse Practitioner 363LA2100X 209.030245 IL

Addresses

Primary practice location

4309 W Medical Center Dr Ste A200
McHenry, IL 60050-8437

Mailing address

4309 W Medical Center Dr Ste A200
McHenry, IL 60050-8437
Phone (815) 759-8180

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911004518 IL Practitioner - Nurse Practitioner 1355881715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

10400 Haligus Rd
Huntley, IL 60142-9553

1200 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1601
Phone (847) 735-8500

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

4309 W Medical Ctr Dr
Suite A201
McHenry, IL 60050-8411
Phone (815) 759-8070

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

Hospital & facility affiliations

  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.030245ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 29, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 29, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

10370 Haligus Rd
Ste 200
Huntley, IL 60142
Phone (815) 759-8070

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4309 W Medical Center Dr
Ste A200
McHenry, IL 60050
Phone (815) 759-4699

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 4

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": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1205665478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508437",
            "telephone_number": "815-759-8180",
            "fax_number": "815-759-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508437",
            "telephone_number": "815-759-8180",
            "fax_number": "815-759-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMEK",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "ACNP, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209030245",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.030245",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.