Organization Active NPI

Shoaib Memon LLC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1700272093
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.127359 Issued in IL
Legal business name
SHOAIB MEMON LLC
Practice address
1741 W Beach Ave Apt 3
Chicago, IL 60622-1185
Phone
(708) 692-5730
NPI assigned
Apr 13, 2015
Last updated
Apr 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Shoaib Memon, M.D.
Title
Manager
Phone
(708) 692-5730

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X 036.127359 IL
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 036.127359 IL Primary

Addresses

Primary practice location

1741 W Beach Ave Apt 3
Chicago, IL 60622-1185

Mailing address

333 N Michigan Ave
Chicago, IL 60601-3901

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1700272093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 W BEACH AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221185",
            "telephone_number": "708-692-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOAIB MEMON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "MEMON",
        "authorized_official_first_name": "SHOAIB",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-692-5730",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "IL",
            "license": "036.127359",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.127359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.