Individual provider Active NPI

Shayna Nathan, APN-CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1528627817
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209019455 Issued in IL
Practice address
1653 W Congress Pkwy Apt 2602
Chicago, IL 60612-3833
Phone
(847) 682-7084
NPI assigned
Jun 10, 2019
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209019455 IL Primary
Family Nurse Practitioner 363LF0000X 209.019455 IL

Addresses

Primary practice location

1653 W Congress Pkwy Apt 2602
Chicago, IL 60612-3833

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

161 W Kinzie St Apt 2602
Chicago, IL 60654-4576
Phone (847) 682-7084

Other practice location 2

1801 W Taylor St
Chicago, IL 60612-4795
Phone (312) 413-2088

Other practice location 3

9977 Woods Dr Ste 100
Skokie, IL 60077-1057
Phone (847) 733-5707

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504002287 IL Practitioner - Nurse Practitioner 3173932118 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.019455ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Mar 16, 2025 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 16, 2025 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1653 W Congress Pkwy
Apt 2602
Chicago, IL 60612
Phone (847) 682-7084

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1528627817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY APT 2602",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "847-682-7084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 W Kinzie St Apt 2602",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544576",
            "country_code": "US",
            "telephone_number": "847-682-7084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-413-2088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9977 Woods Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600771057",
            "country_code": "US",
            "telephone_number": "847-733-5707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "SHAYNA",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019455",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019455",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.