Active NPI
Shilpa Vellookunnel, PA-C
- Physician Assistant
- Chicago, IL
National Provider Identifier
1437718335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.007170
- Practice address
- 675 N Saint Clair St Ste 15-200
Chicago, IL 60611-5967 - Phone
- (312) 695-8182
- NPI assigned
- Jun 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 085.007170 | IL | Primary |
Addresses
Primary practice location
675 N Saint Clair St Ste 15-200
Chicago, IL 60611-5967
Mailing address
8706 W Davis St
Des Plaines, IL 60016-5146
Phone (224) 392-1384
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.11 of 100
- Quality
- 74.7
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 85.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.007170 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Cook County | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
675 N Saint Clair St
Ste 15-200
Chicago, IL 60611
Phone (312) 695-8182
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1821385170
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 27
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": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1437718335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8706 W DAVIS ST",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600165146",
"telephone_number": "224-392-1384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 N SAINT CLAIR ST STE 15-200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115967",
"telephone_number": "312-695-8182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELLOOKUNNEL",
"first_name": "SHILPA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-13",
"last_updated": "2019-08-22",
"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": "085.007170",
"primary": true
}
],
"identifiers": [],
"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 Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.