Active NPI
Victoria Shusharina, M.D
- Hematology (Pathology) Physician
- Tinley Park, IL
National Provider Identifier
1447416482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Pathology) Physician
- License
- 4301097356
- Practice address
- 8150 185TH St
Ste a
Tinley Park, IL 60487-9229 - Phone
- (708) 468-8716
- NPI assigned
- Jul 30, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Pathology) Physician | 207ZH0000X | 4301097356 | MI | Primary |
Addresses
Primary practice location
8150 185TH St
Ste a
Tinley Park, IL 60487-9229
Mailing address
8150 185TH St
Ste a
Tinley Park, IL 60487-9229
Phone (708) 468-8716
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301097356 | MI | MD | Hematology (Pathology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341878400000",
"number": "1447416482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8150 185TH ST",
"address_2": "STE A",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604879229",
"telephone_number": "708-468-8716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8150 185TH ST",
"address_2": "STE A",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604879229",
"telephone_number": "708-468-8716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUSHARINA",
"first_name": "VICTORIA",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-30",
"last_updated": "2012-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZH0000X",
"taxonomy_group": "",
"desc": "Pathology, Hematology",
"state": "MI",
"license": "4301097356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.