Individual provider Active NPI

Kassandra Nicole Shannon

  • Nurse Practitioner
  • Lake Barrington, IL
National Provider Identifier
1699633255
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.034375 Issued in IL
Practice address
22285 N Pepper Rd Ste 310
Lake Barrington, IL 60010-2541
Phone
(847) 382-4410
NPI assigned
Jan 13, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.034375 IL Primary

Addresses

Primary practice location

22285 N Pepper Rd Ste 310
Lake Barrington, IL 60010-2541

Mailing address

22285 N Pepper Rd Ste 311
Lake Barrington, IL 60010-2541

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260401001179 IL Practitioner - Nurse Practitioner 1456836055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gi Partners of Illinois PLLCGroup PAC ID 2567758295, 38 clinicians

Practice addresses (Care Compare)

350 E Congress Pkwy
Suite D
Crystal Lake, IL 60014-6284
Phone (847) 639-2999

Hospital & facility affiliations

  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.034375ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Partners of Illinois, PLLC CurrentSince Feb 21, 2026 Accepting new patients

Locations

350 E Congress Pkwy
Ste D
Crystal Lake, IL 60014
Phone (847) 639-2999

22285 N Pepper Rd
Ste 311
Lake Barrington, IL 60010
Phone (847) 382-4410

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1699633255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD STE 311",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22285 N PEPPER RD STE 310",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102541",
            "telephone_number": "847-382-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KASSANDRA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.034375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Barrington, IL

Sources for this page

Verify at the official NPI Registry.