Individual provider Active NPI

Lemin Kimmy Shimada, CRNA

  • Anesthesiology Physician
  • Berwyn, IL
National Provider Identifier
1699703256
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
209-004505 Issued in IL
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-3667
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 209-004505 IL Primary

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

5912 N Sauganash LN
Chicago, IL 60646-6043

Other practice location 1

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-2210

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lshimada371728@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714000590 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507845658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-9454

Hospital & facility affiliations

  • Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209-004505ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corp. CurrentSince Apr 22, 2023 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Apr 22, 2023 Accepting new patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Apr 20, 2022 Accepting new patients
MN Anesthesia LLC Anesthesiology Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

29373 Network Pl
Chicago, IL 60673

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Interoperability endpoints

  • Direct secure messaging: lshimada371728@direct.myadvocateaurora.org

Organizations & group practices 5

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 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1699703256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 N SAUGANASH LN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-3667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-2210",
            "fax_number": "847-723-3532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMADA",
        "first_name": "LEMIN KIMMY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "209-004505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lshimada371728@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.