Individual provider Active NPI

Aleksey Shub

  • Pharmacist
  • Chicago, IL
National Provider Identifier
1770930216
Registry record updated May 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051294176 Issued in IL
Practice address
4660 W Irving Park Rd
Chicago, IL 60641-2888
Phone
(773) 202-0073
Fax
(773) 202-1195
NPI assigned
May 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051294176 IL Primary

Addresses

Primary practice location

4660 W Irving Park Rd
Chicago, IL 60641-2888

Mailing address

4660 W Irving Park Rd
Chicago, IL 60641-2888
Phone (773) 202-0073

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051294176ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
American Drug Stores LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1463184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463184000000",
    "number": "1770930216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412888",
            "telephone_number": "773-202-0073",
            "fax_number": "773-202-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412888",
            "telephone_number": "773-202-0073",
            "fax_number": "773-202-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUB",
        "first_name": "ALEKSEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-14",
        "last_updated": "2016-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051294176",
            "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 14, 2016; 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.