Individual provider Active NPI

Petro Shafranyuk, MD

  • Hospitalist Physician
  • Dekalb, IL
National Provider Identifier
1669114773
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036174915 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 756-1521
Fax
(815) 748-5789
NPI assigned
Apr 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01096528A IN
Hospitalist Physician 208M00000X 01096528A IN
Internal Medicine Physician 207R00000X 036174915 IL
Hospitalist Physician 208M00000X 036174915 IL Primary

Addresses

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 756-1521

Other practice location 1

1302 N Main St
Sandwich, IL 60548-2587
Phone (815) 786-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250717001840 IL Practitioner - HospitalistPractitioner - Internal Medicine 1254712680 Reassigns benefits to 2 organizations
I20250811002642 IN Practitioner - Internal MedicinePractitioner - Hospitalist 1254712680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 756-1521

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-1600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036174915ILMDInternal Medicine Physician
01096528AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, P.C. Hospitalist CurrentSince Jan 1, 2026 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2025 Accepting new patients
Vituity-California Observation Services PC Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Central Dupage Physician Group Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Jan 1, 2026 Accepting new patients
Vituity-California Observation Services PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

Dept 5777
Carol Stream, IL 60122

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

1302 N Main St
Sandwich, IL 60548
Phone (815) 486-8484

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1669114773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521",
            "fax_number": "815-748-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521",
            "fax_number": "815-748-5789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "IL",
            "postal_code": "605482587",
            "country_code": "US",
            "telephone_number": "815-786-8484",
            "fax_number": "815-981-7356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFRANYUK",
        "first_name": "PETRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-09",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01096528A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01096528A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036174915",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036174915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dekalb, IL

Sources for this page

Verify at the official NPI Registry.