Individual provider Active NPI

Leon Sherrell, PHYSICIANS ASSISTANT

  • Medical Physician Assistant
  • Chicago, IL
National Provider Identifier
1649395930
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085003211 Issued in IL
Practice address
654 E 47TH St
Chicago, IL 60653-4224
Phone
(773) 624-4800
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085003211 IL Primary

Addresses

Primary practice location

654 E 47TH St
Chicago, IL 60653-4224

Mailing address

654 E 47TH St
Chicago, IL 60653-4224
Phone (773) 624-4800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022001190 IL Practitioner - Physician Assistant 2668453085 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jul 23, 2021 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 23, 2021 Accepting new patients
Rosen-Hoffberg Rehabilitation and Pain Management Associates, PA Past Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

7702 Solution Ctr
Chicago, IL 60677

1220 S Wood St
Chicago, IL 60608
Phone (312) 413-1261

7037 S Stony Island Ave
Chicago, IL 60649
Phone (312) 355-5590

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: lsherrell119587@uihealth.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1649395930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534224",
            "telephone_number": "773-624-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534224",
            "telephone_number": "773-624-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRELL",
        "first_name": "LEON",
        "name_prefix": "Mr.",
        "credential": "PHYSICIANS ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085003211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.