Individual provider Active NPI

Shivani Sharma, MD

  • Psychiatry Physician
  • North Chicago, IL
National Provider Identifier
1215342902
Registry record updated Jun 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125.065128 Issued in IL
Practice address
3001 Green Bay Rd
North Chicago, IL 60064-3048
Phone
(847) 578-8711
NPI assigned
Jun 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125.065128 IL Primary

Addresses

Primary practice location

3001 Green Bay Rd
North Chicago, IL 60064-3048

Mailing address

3001 Green Bay Rd
North Chicago, IL 60064-3048

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180717002789 IL Practitioner - Psychiatry 8729374004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

333 N Michigan Ave
Suite 1400
Chicago, IL 60601-4011
Phone (312) 815-9660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.065128ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago BH Hospital, LLC CurrentSince Nov 15, 2022 Accepting new patients
Clarity Clinic PLLC CurrentSince Nov 25, 2024 Accepting new patients
Chicago BH Hospital, LLC Psychiatry CurrentSince Nov 15, 2022 Accepting new patients

Locations

333 N Michigan Ave
Ste 1400
Chicago, IL 60601
Phone (312) 815-9660

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

4720 N Clarendon Ave
Chicago, IL 60640
Phone (773) 313-4401

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1403395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403395200000",
    "number": "1215342902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "847-578-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SHIVANI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-22",
        "last_updated": "2014-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.065128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.