Organization Active NPI

David B. Shanker, M.D.

  • Dermatology Physician
  • Gurnee, IL
National Provider Identifier
1780806091
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DAVID B. SHANKER, M.D.
Practice address
1425 N Hunt Club Rd Ste 204
Gurnee, IL 60031-2635
Phone
(847) 855-0125
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Bryan Shanker
Title
Owner
Phone
(847) 855-0125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X IL Primary

Addresses

Primary practice location

1425 N Hunt Club Rd Ste 204
Gurnee, IL 60031-2635

Mailing address

1425 N Hunt Club Rd Ste 204
Gurnee, IL 60031-2635
Phone (847) 855-0125

National Provider Directory

National Provider Directory
Tax ID family
David B Shanker2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1425 N Hunt Club Rd
Ste 204
Gurnee, IL 60031
Phone (847) 855-0125

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780806091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N HUNT CLUB RD STE 204",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312635",
            "telephone_number": "847-855-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N HUNT CLUB RD STE 204",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312635",
            "telephone_number": "847-855-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B. SHANKER, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-855-0125"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.