Jeffrey Shanes, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036-064782 Issued in IL

Practice address

675 W North Ave
Suite-210
Melrose Park, IL 60160-1634

Phone

(708) 838-1448

Fax

(708) 344-0508

NPI assigned

May 26, 2006

Last updated

Jan 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshanes292086@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Medicare reassignment NPD
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment NPD
• Consultants in Cardiovascular Medicine, S. C.

  • Specialist
  • Melrose Park, IL
  • NPI 1164530713
  Authorized official Same address or phone
• Advocate Health & Hospitals Corporation

  dba Advocate Christ Medical Group

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1740236835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE-210",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-838-1448",
            "fax_number": "708-344-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE-210",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-838-1448",
            "fax_number": "708-344-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANES",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-064782",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036-064782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN NUMBER",
            "identifier": "CC1592",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN FOR LOALITY 015",
            "identifier": "K51366",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE INDIVIDUAL PROVIDER ID NUMBER",
            "identifier": "110032830",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-064782",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD GROUP PROVIDER NUMBER",
            "identifier": "31602469",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN NUMBER",
            "identifier": "L18915",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "209712",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN FOR LOCALITY 015",
            "identifier": "216577",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER FOR CONSULTANTS IN CARDIOVASCULAR MEDICINE, S.C.",
            "identifier": "961280",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER FOR CONSULTANTS IN CARDIOVASCULAR MEDICINE S C",
            "identifier": "1164530713",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayur V Shah, PHARM.D.
• Priti Mayur Shah, PHARM.D.
• Rachna Shah, M.D.
• Suhani Shail Shah
• Kevin Jude Shanahan
• Violette Genevieve Shearer
• Dilmubarak Sheikh, DDS
• Deepti Shivakumar, MD
• Shobhana Patodia
• Lisa M. Shurba, DIETICIAN REGISTERED

• Interventional Cardiology Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.