Individual provider Active NPI

Shameeta Vinod Thanki, D.O.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1437491834
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036.143223 Issued in IL
Practice address
836 W Wellington Ave
Chicago, IL 60657
Phone
(773) 975-1600
NPI assigned
Mar 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036.143223 IL Primary

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657

Mailing address

7625 Wakefield Dr
Darien, IL 60561-4321
Phone (630) 229-7944

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sthanki227429@direct.luhs.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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180521000527 IL Practitioner - Anesthesiology 7911297577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiologists SCGroup PAC ID 4183512080, 152 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-3138

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.143223ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gottlieb Community Health Services Corporation CurrentSince Aug 8, 2023 Accepting new patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Jun 11, 2018 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Aug 8, 2023 Accepting new patients
University Anesthesiologists SC Anesthesiology CurrentSince Sep 1, 2024 Accepting new patients

Locations

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1653 W Congress Pkwy
#739
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

125 N La Grange Rd
La Grange, IL 60525
Phone (708) 354-4900

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

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.

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": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1437491834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 WAKEFIELD DR",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614321",
            "telephone_number": "630-229-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-975-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANKI",
        "first_name": "SHAMEETA",
        "middle_name": "VINOD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.143223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sthanki227429@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "836 W Wellington Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.