Individual provider Active NPI

Neha Shah Thengil, FNP

  • Family Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1629520549
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014600 Issued in IL
Practice address
2400 Big Timber Rd Ste 200
Elgin, IL 60124-7835
Phone
(847) 697-0770
Fax
(847) 697-0789
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209014600 IL Primary

Addresses

Primary practice location

2400 Big Timber Rd Ste 200
Elgin, IL 60124-7835

Mailing address

2400 Big Timber Rd Ste 200
Elgin, IL 60124-7835
Phone (847) 697-0770

Other identifiers 1

IdentifierTypeStateIssuer
785310MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address manager@associatesinendocrinology.com Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
209014600ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Zurich Physical Medicine, SC PastSince Feb 1, 2017 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1629520549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BIG TIMBER RD STE 200",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601247835",
            "telephone_number": "847-697-0770",
            "fax_number": "847-697-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BIG TIMBER RD STE 200",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601247835",
            "telephone_number": "847-697-0770",
            "fax_number": "847-697-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THENGIL",
        "first_name": "NEHA",
        "middle_name": "SHAH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "785310",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manager@associatesinendocrinology.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2400 Big Timber Rd Ste 200",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601247835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.