Active NPI
Jennifer Shih, M.D.
- Family Medicine Physician
- Oak Lawn, IL
National Provider Identifier
1679763023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A100844
- Practice address
- 5660 W 95TH St
Suite 1
Oak Lawn, IL 60453-2380 - Phone
- (708) 499-2273
- Fax
- (708) 857-4435
- NPI assigned
- Jul 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036121868 | IL | |
| Family Medicine Physician | 207Q00000X | A100844 | CA | Primary |
Addresses
Primary practice location
5660 W 95TH St
Suite 1
Oak Lawn, IL 60453-2380
Mailing address
5660 W 95TH St
Suite 1
Oak Lawn, IL 60453-2380
Phone (708) 499-2273
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100844 | CA | MD | Social Worker |
| A100844 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637193600000",
"number": "1679763023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5660 W 95TH ST",
"address_2": "SUITE 1",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532380",
"telephone_number": "708-499-2273",
"fax_number": "708-857-4435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5660 W 95TH ST",
"address_2": "SUITE 1",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532380",
"telephone_number": "708-499-2273",
"fax_number": "708-857-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIH",
"first_name": "JENNIFER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-31",
"last_updated": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036121868",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A100844",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4647 Zion Ave",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921202507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.