Active NPI
Shane Jay Nho, M.D.
- Sports Medicine (Orthopaedic Surgery) Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 036-120601
- Practice address
- 1611 W Harrison St
Ste 400
Chicago, IL 60612-3841 - Phone
- (312) 243-4244
- Fax
- (312) 942-1517
- NPI assigned
- May 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 036-120601 | IL | Primary |
Addresses
Primary practice location
1611 W Harrison St
Ste 400
Chicago, IL 60612-3841
Mailing address
1 Westbrook Corporate Ctr
#240
Westchester, IL 60154-5701
Phone (708) 236-2673
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| # 1633878 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- Rush Medical College of Rush University, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637
9601 Calumet Ave
Munster, IN 46321-2871
Phone (877) 632-6637
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 26 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-120601 | IL | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthomidwest, PLLC | Sports Medicine | Current | Accepting new patients |
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060
1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244
1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244
1611 W Harrison St
Chicago, IL 60612
Phone (312) 243-4244
963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425
324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339
1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154
9200 Calumet Ave
#300
Munster, IN 46321
9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591
Interoperability endpoints
- shane.nho.1@12576.direct.athenahealth.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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Buffalo Grove, IL
- NPI 1043180839
-
- Durable Medical Equipment & Medical Supplies
- McHenry, IL
- NPI 1346866373
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1669649158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WESTBROOK CORPORATE CTR",
"address_2": "#240",
"city": "WESTCHESTER",
"state": "IL",
"postal_code": "601545701",
"telephone_number": "708-236-2673",
"fax_number": "708-492-5673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST",
"address_2": "STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-243-4244",
"fax_number": "312-942-1517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NHO",
"first_name": "SHANE",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-13",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IL",
"license": "036-120601",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "# 1633878",
"state": "IL"
}
],
"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 Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.