Individual provider Active NPI

Allison K Shewmake

  • Family Medicine Physician
  • South Holland, IL
National Provider Identifier
1669047460
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
277.003215 Issued in IL
Practice address
16145 Lasalle St
South Holland, IL 60473
Phone
(708) 331-0711
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 277.003215 IL Primary

Addresses

Primary practice location

16145 Lasalle St
South Holland, IL 60473

Mailing address

16145 Lasalle St
South Holland, IL 60473
Phone (708) 331-0711

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
I20210709002533 IL Practitioner - Nurse Practitioner 1052713237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277.003215ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1669047460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16145 LASALLE ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "60473",
            "telephone_number": "708-331-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16145 LASALLE ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "60473",
            "telephone_number": "708-331-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEWMAKE",
        "first_name": "ALLISON",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "277.003215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

Verify at the official NPI Registry.