Individual provider Active NPI

Shubham Agarwal

  • Internal Medicine Physician
  • North Chicago, IL
National Provider Identifier
1326690181
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.074081 Issued in IL
Practice address
3333 Green Bay Rd
North Chicago, IL 60064-3037
Phone
(847) 578-3227
NPI assigned
Jul 11, 2019
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.074081 IL Primary

Addresses

Primary practice location

3333 Green Bay Rd
North Chicago, IL 60064-3037

Mailing address

3333 Green Bay Rd # Bsb1363A
North Chicago, IL 60064-3037
Phone (847) 578-3227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20241206002992 NE Practitioner - Endocrinology 9335675834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unmc PhysiciansGroup PAC ID 6002728391, 1,490 clinicians

Practice addresses (Care Compare)

Emile 42ND St
Omaha, NE 68198-0001
Phone (402) 559-4015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.074081ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unmc Physicians CurrentSince Oct 3, 2024 Accepting new patients

Locations

Emile 42nd St
Omaha, NE 68198
Phone (402) 552-6731

Interoperability endpoints

  • Direct secure messaging: sagarwal298305@direct.phhs.org
  • Direct secure messaging: sagarwal488230@direct.nebraskamed.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1326690181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD # BSB1363A",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037",
            "telephone_number": "847-578-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037",
            "telephone_number": "847-578-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "SHUBHAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.074081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.