NPIMap

Individual provider Active NPI

Yury M Shklyar, M.D.

  • Family Medicine Physician
  • Libertyville, IL
National Provider Identifier
1558440404
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036090663 Issued in IL
Practice address
1870 W Winchester Rd
Suite 144
Libertyville, IL 60048-5358
Phone
(847) 680-1200
Fax
(847) 680-1211
NPI assigned
Nov 3, 2006
Last updated
Aug 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036090663 IL Primary

Addresses

Primary practice location

1870 W Winchester Rd
Suite 144
Libertyville, IL 60048-5358

Mailing address

1870 W Winchester Rd
Suite 144
Libertyville, IL 60048-5358
Phone (847) 680-1200

Other identifiers 1

IdentifierTypeStateIssuer
036090663MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006000286 IL Practitioner - Family Practice 5193785871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yury M Shklyar MD PCGroup PAC ID 5294795977, 2 clinicians

Practice addresses (Care Compare)

1870 W Winchester Rd
Suite 144
Libertyville, IL 60048-5359
Phone (847) 680-1200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.64 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
61.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036090663ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yury M Shklyar MD PC Family Medicine CurrentSince Jul 18, 2000 Accepting new patients
Aaa Headache and Pain Clinic LTD PastSince Jul 18, 2000 Accepting new patients

Locations

1170 E Belvidere Rd
Ste 202
Grayslake, IL 60030
Phone (847) 566-0300

1870 W Winchester Rd
Libertyville, IL 60048
Phone (847) 816-7495

1870 W Winchester Rd
Ste 144
Libertyville, IL 60048
Phone (847) 548-5063

Interoperability endpoints

  • Direct secure messaging: yshklyar236414@direct.myadvocateaurora.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Accord Hospice IncDeerfield, IL, CCN 141650 Hospice Contracted Managing Employee (5%) Apr 6, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1558440404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD",
            "address_2": "SUITE 144",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485358",
            "telephone_number": "847-680-1200",
            "fax_number": "847-680-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD",
            "address_2": "SUITE 144",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485358",
            "telephone_number": "847-680-1200",
            "fax_number": "847-680-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHKLYAR",
        "first_name": "YURY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036090663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090663",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.