Individual provider Active NPI

Shraddha Pathak, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1275296972
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008482 Issued in IL
Practice address
3021 N Sheffield Ave
Chicago, IL 60657-4419
Phone
(872) 843-0550
Fax
(872) 873-9070
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008482 IL Primary

Addresses

Primary practice location

3021 N Sheffield Ave
Chicago, IL 60657-4419

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

420 N Il Route 31
Crystal Lake, IL 60012-3709
Phone (815) 356-5200

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address spathak405590@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20211217000941 IL Practitioner - Physician Assistant 5496146953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1435 W Webster Ave
Chicago, IL 60614-3049
Phone (630) 368-1771

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

3021 N Sheffield Ave
Chicago, IL 60657-4419
Phone (872) 843-0550

836 W Wellington
Suite G346
Chicago, IL 60657-5147
Phone (773) 296-7147

836 W Wellington Ave
Chicago, IL 60657-5147

Hospital & facility affiliations

  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008482ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corp. CurrentSince Jul 26, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 26, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

1435 W Webster Ave
Chicago, IL 60614
Phone (773) 356-7733

29373 Network Pl
Chicago, IL 60673

3021 N Sheffield Ave
Chicago, IL 60657
Phone (773) 296-7450

Interoperability endpoints

  • Direct secure messaging: spathak405590@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 1

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": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1275296972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 N SHEFFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574419",
            "telephone_number": "872-843-0550",
            "fax_number": "872-873-9070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 N Il Route 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600123709",
            "country_code": "US",
            "telephone_number": "815-356-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHAK",
        "first_name": "SHRADDHA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spathak405590@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3021 N Sheffield Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3021 N Sheffield Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.