Mark Shukhman, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-103040 Issued in IL

Practice address

4711 Golf Rd
Suite 1200
Skokie, IL 60076-1224

Phone

(847) 563-4488

Fax

(847) 929-9355

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

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.

• Associates in Psychiatric Wellness, LP

  • Psychiatry Physician
  • Skokie, IL
  • NPI 1629181243

  IL

  Medicare reassignment Care Compare group Authorized official
• Chicago Integrative Center for Psychology LLC

  • Psychiatry Physician
  • Lake Bluff, IL
  • NPI 1649785486

  IL, Psychiatry

  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Psychiatry

  NPD
• Maine Center, Inc.

  • Community/Behavioral Health Agency
  • Park Ridge, IL
  • NPI 1518087188
  NPD (past)

Specialty

PsychiatryAlso: Addiction Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associates in Psychiatric Wellness LP 9 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: markshukhman@tdh.allscriptsdirect.net

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1225087752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-563-4488",
            "fax_number": "847-929-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-563-4488",
            "fax_number": "847-929-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKHMAN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-103040",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "IL",
            "license": "036-103040",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036-103040",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IL",
            "license": "36-103040",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-103040",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shore Community Services Inc
• Shore Community Services, Inc.
• Wendy Ellen Shorr, D.D.S.
• Sanjina Shrestha, APN-CNP
• Carolee Shudnow, LCPC
• Rebecca Pamela Shukhman, DO
• Joseph Michael Shulan, D.O.
• Mikhail Shulman, FNP-C
• Deanne Lynne Shvartsman, O.D.
• Lynn Shyman, LCSW

• All providers in Skokie, IL
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.

Verify at the official NPI Registry.