Individual provider Active NPI

Shems Al-Taie, FNP-C

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1770127029
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024059 Issued in IL
Practice address
5461 West Lake Street
Chicago, IL 60644
Phone
(312) 866-7058
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041472081 IL
Family Nurse Practitioner 363LF0000X 209024059 IL Primary

Addresses

Primary practice location

5461 West Lake Street
Chicago, IL 60644

Mailing address

5461 W Lake Street
Chicago, IL 60644
Phone (312) 866-7058

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041472081ILMDRegistered Nurse
209024059ILMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: shems.al-taie.1@13158.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1770127029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 W LAKE STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60644",
            "telephone_number": "312-866-7058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 WEST LAKE STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60644",
            "telephone_number": "312-866-7058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-TAIE",
        "first_name": "SHEMS",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041472081",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024059",
            "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 May 21, 2025; 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.