Individual provider Active NPI

Shaina Kristen Chechang, DDS, MS, MBS

  • Dentist
  • Chicago, IL
National Provider Identifier
1679212872
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.033622 Issued in IL
Practice address
801 S Paulina St RM 110
Chicago, IL 60612-7210
Phone
(847) 848-4444
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 019.033622 IL
Dentist 122300000X 019.033622 IL Primary

Addresses

Primary practice location

801 S Paulina St RM 110
Chicago, IL 60612-7210

Mailing address

801 S Paulina St RM 110
Chicago, IL 60612-7210
Phone (312) 996-1052

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917001924 IL Practitioner - Dentist 0143609529 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019.033622ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Sep 5, 2024 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 5, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

801 S Paulina St
Rm 110
Chicago, IL 60612
Phone (312) 996-1052

7702 Solution Ctr
Chicago, IL 60677

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

Interoperability endpoints

  • Direct secure messaging: schechang136456@uihealth.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1679212872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST RM 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-996-1052",
            "fax_number": "312-996-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST RM 110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "847-848-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHECHANG",
        "first_name": "SHAINA",
        "middle_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS, MBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.033622",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.