Active NPI
Shebere Adam, MD
- Student in an Organized Health Care Education/Training Program
- Chicago, IL
National Provider Identifier
1619608148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1950 W Polk St
Chicago, IL 60612-3723 - Phone
- (312) 864-7114
- NPI assigned
- Jun 24, 2022
- Last updated
- Jun 24, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | Primary |
Addresses
Primary practice location
1950 W Polk St
Chicago, IL 60612-3723
Mailing address
1950 W Polk St
Chicago, IL 60612-3723
Phone (312) 864-7114
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | skip | Other | John H. Stroger, Jr. Hospital of Cook County |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220816002635 | IL | Order and Referring Only - Family Practice | 0042693533 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1619608148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 W POLK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123723",
"telephone_number": "312-864-7114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 W POLK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123723",
"telephone_number": "312-864-7114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAM",
"first_name": "SHEBERE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-24",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "skip",
"affiliation": "Y",
"endpointDescription": "skip",
"affiliationName": "John H. Stroger, Jr. Hospital of Cook County",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "skip",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "skip",
"address_1": "1950 W Polk St",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606123723",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jun 24, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.