Carlos S. Shibata, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

036-46356 Issued in IL

Practice address

800 Biesterfield Rd
Elk Grove Village, IL 60007-3311

Phone

(847) 437-5500

Fax

(847) 981-2023

NPI assigned

Jul 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Elk Grove Lab Physicians, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Elk Grove Village, IL
  • NPI 1447289210
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497784250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77-9154",
            "address_2": "DEPT 77-9154",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606780001",
            "telephone_number": "847-437-5500",
            "fax_number": "847-981-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-437-5500",
            "fax_number": "847-981-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBATA",
        "first_name": "CARLOS",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036-46356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy Shapiro, APN, CNP
• Rachel Sharp
• David S Shaw, DO
• Ronald M Shenfeld, MD
• Kamran Khan Sherwani, M.D.
• Shine Early LTD
• Larry Lon Shoemake
• Alvia Habeeb Siddiqi, MD
• Maryam Siddiqui
• Donatas A. Siliunas, M.D.

• Anatomic Pathology & Clinical Pathology Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.