Individual provider Active NPI

Shankar Das, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1316060965
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036119559 Issued in IL
Practice address
8700 S Dante Ave
Chicago, IL 60619-7118
Phone
(773) 221-3900
NPI assigned
Apr 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036119559 IL Primary

Addresses

Primary practice location

8700 S Dante Ave
Chicago, IL 60619-7118

Mailing address

9680 Golf Rd
Second Floor
Des Plaines, IL 60016-1522
Phone (847) 502-4156

Other identifiers 1

IdentifierTypeStateIssuer
036119559MedicaidIL

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Medical Centers of Illinois, LTD. Family Medicine CurrentSince Apr 23, 2013 Accepting new patients
Illinois Back and Joint PLLC Family Medicine PastSince Jan 19, 2023 Accepting new patients
Countryview Medical Center SC Past Accepting new patients
Wheaton Medical SC Family Medicine PastSince Nov 6, 2012 Accepting new patients
Countryside Medical SC Past Accepting new patients

Locations

7531 S Stony Island Ave
Ste 176
Chicago, IL 60649
Phone (773) 288-1644

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

Organizations & group practices 5

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1316060965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9680 GOLF RD",
            "address_2": "SECOND FLOOR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161522",
            "telephone_number": "847-502-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 S DANTE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606197118",
            "telephone_number": "773-221-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "SHANKAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036119559",
            "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.

Verify at the official NPI Registry.