Individual provider Active NPI

Lauren H Shin, M.D.

  • Psychiatry Physician
  • Hoffman Estates, IL
National Provider Identifier
1508812173
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-112664 Issued in IL
Practice address
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone
(847) 755-8090
Fax
(847) 843-7393
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-112664 IL Primary

Addresses

Primary practice location

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029

Mailing address

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090

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
I20110323000650 IL Practitioner - PsychiatryPractitioner - Other (Physician) 1658469366 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-112664ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Behavioral Health Hospital CurrentSince Nov 1, 2012 Accepting new patients
Alexian Brothers Behavioral Health Hospital Psychiatry CurrentSince Nov 1, 2012 Accepting new patients

Locations

1650 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (800) 432-5005

1786 Moon Lake Blvd
Ste 104
Hoffman Estates, IL 60169

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/aa9a3bec-4c8c-4fc5-b283-495def30e623/
  • FHIR API: https://api.platform.athenahealth.com/380/brand/6/csg/181/fhir/r4
  • Direct secure messaging: lauren.shin.1@15182.direct.athenahealth.com
  • FHIR API: https://epicmobile.presencehealth.org/fhirPRD/api/FHIR/R4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1508812173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "LAUREN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-112664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.