NPIMap

Individual provider Active NPI

Alexander Shaw, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1609367119
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036156823 Issued in IL
Practice address
6084 S Archer Ave
Chicago, IL 60638-2747
Phone
(773) 355-2800
NPI assigned
May 21, 2018
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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 036156823 IL Primary

Addresses

Primary practice location

6084 S Archer Ave
Chicago, IL 60638-2747

Mailing address

6084 S Archer Ave
Chicago, IL 60638-2747
Phone (773) 355-2800

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
I20210803001562 IL Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 0749616563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventist Midwest HealthGroup PAC ID 2769790401, 13 clinicians
Adventist Health Partners, Inc.Group PAC ID 0244135762, 253 clinicians

Practice addresses (Care Compare)

1325 Community Memorial Dr
La Grange, IL 60525-2659
Phone (708) 245-8900

396 Remington Blvd
Bolingbrook, IL 60440-4311

5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 245-9000

6084 S Archer Ave
Chicago, IL 60638-2747
Phone (773) 229-8508

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Partners,Inc Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Adventist Midwest Health CurrentSince May 16, 2024 Accepting new patients
Adventist Health Partners, Inc. Family Medicine CurrentSince Apr 1, 2024 Accepting new patients
Adventist Midwest Health Family Medicine CurrentSince May 16, 2024 Accepting new patients
Adventist Health Partners, Inc. Current Accepting new patients
Adventist Health Partners,Inc Family Medicine Past Accepting new patients

Locations

396 Remington Blvd
Ste 231
Bolingbrook, IL 60440
Phone (630) 312-4301

6084 S Archer Ave
Chicago, IL 60638
Phone (708) 442-0221

1325 Memorial Dr
Lagrange Hlds, IL 60525
Phone (708) 245-8900

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

Interoperability endpoints

  • Direct secure messaging: ashaw143200@direct.luhs.org
  • Direct secure messaging: ashaw2772015@adventhealth.direct-ci.com

Organizations & group practices 7

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 10

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": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1609367119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6084 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382747",
            "telephone_number": "773-355-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6084 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382747",
            "telephone_number": "773-355-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036156823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.