Individual provider Active NPI

Purvi Shah, M.D.

  • Internal Medicine Physician
  • Lincolnwood, IL
National Provider Identifier
1598920308
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036123606 Issued in IL
Practice address
6810 N McCormick Blvd
Lincolnwood Primary Care
Lincolnwood, IL 60712-2709
Phone
(847) 674-6900
NPI assigned
Jul 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036123606 IL Primary

Addresses

Primary practice location

6810 N McCormick Blvd
Lincolnwood Primary Care
Lincolnwood, IL 60712-2709

Mailing address

516 Keeney St
Evanston, IL 60202-3044
Phone (847) 866-5762

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pshah203698@direct.northshore.org

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
I20090810000610 IL Practitioner - Internal Medicine 6305990318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Vanderbilt University School of Medicine, 2006
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

6810 N McCormick Blvd
Lincolnwood, IL 60712-2709
Phone (847) 674-6900

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Sep 1, 2009 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Sep 1, 2009 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

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

6810 N McCormick Blvd
Lincolnwood, IL 60712
Phone (847) 674-6900

Interoperability endpoints

  • Direct secure messaging: pshah203698@direct.northshore.org

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 3

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": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1598920308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 KEENEY ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023044",
            "telephone_number": "847-866-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 N MCCORMICK BLVD",
            "address_2": "LINCOLNWOOD PRIMARY CARE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122709",
            "telephone_number": "847-674-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PURVI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036123606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pshah203698@direct.northshore.org",
            "affiliation": "N",
            "address_1": "6810 N McCormick Blvd",
            "address_2": "Lincolnwood Primary Care",
            "city": "Lincolnwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "607122709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

Verify at the official NPI Registry.