Vidya Shivakumar, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036137305 Issued in IL

Practice address

839 W Madison St
Chicago, IL 60607-2631

Phone

(312) 455-3500

Fax

(312) 455-3502

NPI assigned

Mar 21, 2012

Last updated

Jan 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Rush Medical College of Rush University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Dermatology

  Medicare reassignment Care Compare group NPD
• Cook County

  dba John H. Stroger, Jr. Hospital of Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1134433154
  Medicare reassignment NPD
• Cook County

  dba Cook County Health & Hospitals System Physician Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170

  Dermatology

  NPD
• Cook County

  dba Bronzeville Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Obstetrics Physician
  • Arlington Heights, IL
  • NPI 1467057513
  NPD
• Rush University Medical Center

  dba Rush Oak Brook

  • Internal Medicine Physician
  • Oak Brook, IL
  • NPI 1801375696

  Dermatology

  NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)

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

• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1558636647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072631",
            "telephone_number": "312-455-3500",
            "fax_number": "312-455-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072631",
            "telephone_number": "312-455-3500",
            "fax_number": "312-455-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVAKUMAR",
        "first_name": "VIDYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "125.059296",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036137305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036137305",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley S Wong M.D.S.C.
• Davida Shirley
• Kanika Shirole
• Shiv Pharmacy Incorporation (Shiv Pharmacy Inc)
• Shivaadi Corporation (Bridgeport Neighborhood Pharmacy)
• Fnu Shivani
• Anupama Shivaraju, M.D.
• Kavya Shivashankar, MD
• Armin Shivazad, M.D.
• Anuradha Shivde, M.D.

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.