Active NPI
Shelly Vijay, M.D.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1649559212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036.129049
- Practice address
- 2361 Paysphere Circle
Chicago, IL 60674 - Phone
- (847) 746-4358
- NPI assigned
- Aug 12, 2011
- Last updated
- Feb 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | IL | ||
| Internal Medicine Physician | 207R00000X | 036.129049 | IL | Primary |
Addresses
Primary practice location
2361 Paysphere Circle
Chicago, IL 60674
Mailing address
2520 Elisha Avenue
Zion, IL 60099
Phone (847) 872-6259
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.129049 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423526400000",
"number": "1649559212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 ELISHA AVENUE",
"city": "ZION",
"state": "IL",
"postal_code": "60099",
"telephone_number": "847-872-6259",
"fax_number": "847-872-5716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2361 PAYSPHERE CIRCLE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60674",
"telephone_number": "847-746-4358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIJAY",
"first_name": "SHELLY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-12",
"last_updated": "2015-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.129049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Feb 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.