Individual provider Active NPI

Shannon M. Ewing, M.D.

  • Dermatology Physician
  • Skokie, IL
National Provider Identifier
1598845695
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Practice address
9977 Woods Dr
3Rd Floor
Skokie, IL 60077-1057
Phone
(847) 663-8060
Fax
(847) 663-1027
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X IL Primary

Addresses

Primary practice location

9977 Woods Dr
3Rd Floor
Skokie, IL 60077-1057

Mailing address

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1644

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050914000408 IL Practitioner - Dermatology 0547293292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Medical College of Wisconsin, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

4901 Searle Pkwy
Suite 150
Skokie, IL 60077-1057

9977 Woods Dr
Skokie, IL 60077-1057
Phone (847) 663-8062

9977 Woods Dr 2ND Floor
Skokie, IL 60077-1057
Phone (847) 663-8370

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision28
Removal of skin lesions628
Removal or shaving of skin growth1-10
Skin biopsy207

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Dermatology Current Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 16, 2001 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

9669 Kenton Ave
Ste 602
Skokie, IL 60076
Phone (847) 674-4344

9977 Woods Dr
Fl 3
Skokie, IL 60077
Phone (847) 663-8410

9933 Woods Dr
Skokie, IL 60077
Phone (847) 663-8060

9933 Woods Dr
Ste 200
Skokie, IL 60077
Phone (847) 663-8060

830 W End Ct
Ste 500
Vernon Hills, IL 60061
Phone (847) 522-8900

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598845695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1644",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "address_2": "3RD FLOOR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-8060",
            "fax_number": "847-663-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWING",
        "first_name": "SHANNON",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.