Active NPI
Antoin Deshaun Shinaul
- Athletic Trainer
- Chicago, IL
National Provider Identifier
1568868933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096003501
- Practice address
- 205 W Wacker Dr Ste 1020
Chicago, IL 60606-1452 - Phone
- (312) 640-0329
- Fax
- (312) 640-0407
- NPI assigned
- Nov 13, 2014
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096003501 | IL | Primary |
Addresses
Primary practice location
205 W Wacker Dr Ste 1020
Chicago, IL 60606-1452
Mailing address
5381 Burr Oak Rd
Lisle, IL 60532-2107
Phone (773) 543-1752
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096003501 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415836800000",
"number": "1568868933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5381 BURR OAK RD",
"city": "LISLE",
"state": "IL",
"postal_code": "605322107",
"telephone_number": "773-543-1752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 W WACKER DR STE 1020",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606061452",
"telephone_number": "312-640-0329",
"fax_number": "312-640-0407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINAUL",
"first_name": "ANTOIN",
"middle_name": "DESHAUN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-13",
"last_updated": "2014-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096003501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.