Active NPI
Shay Golan, M.D.
- Urology Physician
- Chicago, IL
National Provider Identifier
1790164002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 125066106
- Practice address
- 5841 S Maryland Ave Mc6038
Chicago, IL 60637-1447 - Phone
- (773) 702-6760
- Fax
- (773) 702-1001
- NPI assigned
- May 20, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 125066106 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave Mc6038
Chicago, IL 60637-1447
Mailing address
5841 S Maryland Ave Mc6038
Chicago, IL 60637-1447
Phone (773) 702-6760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1790164002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE MC6038",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-702-6760",
"fax_number": "773-702-1001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE MC6038",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-702-6760",
"fax_number": "773-702-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLAN",
"first_name": "SHAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-20",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "125066106",
"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, 2015; 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.