Active NPI
Dean P Shoener, MD
- Surgery Physician
- Geneva, IL
National Provider Identifier
1528063559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036099967
- Practice address
- 1665 South St
Geneva, IL 60134-2542 - Phone
- (630) 208-7874
- Fax
- (630) 208-7880
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036099967 | IL | Primary |
Addresses
Primary practice location
1665 South St
Geneva, IL 60134-2542
Mailing address
1665 South St
Geneva, IL 60134-2542
Phone (630) 208-7874
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206147 | Other | IL | MEDICARE PTAN GROUP |
| 036099967 | Medicaid | IL | |
| F400118964 | Other | IL | MEDICARE INDIVIDUAL PTAN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036099967 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398988800000",
"number": "1528063559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1665 SOUTH ST",
"city": "GENEVA",
"state": "IL",
"postal_code": "601342542",
"telephone_number": "630-208-7874",
"fax_number": "630-208-7880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1665 SOUTH ST",
"city": "GENEVA",
"state": "IL",
"postal_code": "601342542",
"telephone_number": "630-208-7874",
"fax_number": "630-208-7880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOENER",
"first_name": "DEAN",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2014-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036099967",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN GROUP",
"identifier": "206147",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036099967",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL PTAN",
"identifier": "F400118964",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.