Individual provider Active NPI

Shan Pandya, DO

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1689363319
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036179804 Issued in IL
Practice address
1620 W Harrison St
Chicago, IL 60612-3801
Phone
(312) 942-5000
NPI assigned
May 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.081646 IL
Nephrology Physician 207RN0300X 036179804 IL Primary

Addresses

Primary practice location

1620 W Harrison St
Chicago, IL 60612-3801

Mailing address

1620 W Harrison St
Chicago, IL 60612-3801
Phone (630) 205-7479

Other practice location 1

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.081646ILMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: spandya644657@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1689363319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "630-205-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5145 N California Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606253661",
            "country_code": "US",
            "telephone_number": "773-878-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDYA",
        "first_name": "SHAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.081646",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036179804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.