NPIMap

Individual provider Active NPI

Shoshana Elkin Waskow, MD

  • Pediatrics Physician
  • Wilmette, IL
National Provider Identifier
1679648125
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036095927 Issued in IL
Practice address
1144 Wilmette Ave
Wilmette, IL 60091-2604
Phone
(847) 256-6480
Fax
(847) 256-6482
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036095927 IL Primary

Addresses

Primary practice location

1144 Wilmette Ave
Wilmette, IL 60091-2604

Mailing address

1144 Wilmette Ave
Wilmette, IL 60091-2604
Phone (847) 256-6480

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036095927ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ann & Robert H. Lurie Children'S Hospital of Chicago Current Accepting new patients
Peter R. Lewy, MD, LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: swaskow113822@direct.luriechildrens.org

Organizations & group practices 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1679648125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 WILMETTE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912604",
            "telephone_number": "847-256-6480",
            "fax_number": "847-256-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 WILMETTE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912604",
            "telephone_number": "847-256-6480",
            "fax_number": "847-256-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASKOW",
        "first_name": "SHOSHANA",
        "middle_name": "ELKIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036095927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.