Individual provider Active NPI

Shailar Kristine Webber

  • Physician Assistant
  • Park Ridge, IL
National Provider Identifier
1356045306
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009893 Issued in IL
Practice address
1700 Luther LN
Park Ridge, IL 60068-1270
Phone
(847) 723-7306
Fax
(847) 723-2333
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 085.009893 IL Primary

Addresses

Primary practice location

1700 Luther LN
Park Ridge, IL 60068-1270

Mailing address

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

Other practice location 1

3727 N Milwaukee Ave Apt 201
Chicago, IL 60641-3054
Phone (224) 637-6167

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address swebber351718@direct.myadvocateaurora.org Direct

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
I20231013000354 IL Practitioner - Physician Assistant 5597110320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

1357 W 103Rd St
Adv Med GRP Evergreen
Chicago, IL 60643-2392
Phone (773) 238-0800

1700 Luther LN
Park Ridge, IL 60068-1270

1775 Dempster St
Park Ridge, IL 60068-1143

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

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.009893ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Sep 23, 2023 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 23, 2023 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

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

9831 S Western Ave
Chicago, IL 60643
Phone (773) 445-3500

29373 Network Pl
Chicago, IL 60673

1700 Luther Ln
Park Ridge, IL 60068
Phone (847) 268-8200

Interoperability endpoints

  • Direct secure messaging: swebber351718@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 3

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1356045306",
    "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",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 LUTHER LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681270",
            "telephone_number": "847-723-7306",
            "fax_number": "847-723-2333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3727 N Milwaukee Ave Apt 201",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606413054",
            "country_code": "US",
            "telephone_number": "224-637-6167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "SHAILAR",
        "middle_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1700 Luther Ln",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swebber351718@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 Luther Ln",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.