Active NPI
Sheldon Edelson, M.D.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1265497069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- IL036049349
- Practice address
- 849 W. Fullerton
Chicago, IL 60614 - Phone
- (773) 865-2531
- Fax
- (773) 549-3275
- NPI assigned
- Apr 18, 2006
- Last updated
- Jun 20, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL036049349 | IL | Primary |
Addresses
Primary practice location
849 W. Fullerton
Chicago, IL 60614
Mailing address
849 W Fullerton Ave
Chicago, IL 60614-2412
Phone (773) 865-2531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0021608860 | Other | IL | BLUECROSS/BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IL036049349 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403222400000",
"number": "1265497069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "849 W FULLERTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606142412",
"telephone_number": "773-865-2531",
"fax_number": "773-549-3275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "849 W. FULLERTON",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60614",
"telephone_number": "773-865-2531",
"fax_number": "773-549-3275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELSON",
"first_name": "SHELDON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2014-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "IL036049349",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "0021608860",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.