Individual provider Active NPI

Shubhra Mukherjee, MD

  • Pediatric Rehabilitation Medicine Physician
  • Chicago, IL
National Provider Identifier
1790770659
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
036-102847 Issued in IL
Practice address
2211 N Oak Park Ave
Chicago, IL 60707-3392
Phone
(773) 385-5463
Fax
(773) 385-5488
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-102847 IL
Physical Medicine & Rehabilitation Physician 208100000X 036-102847 IL
Pediatric Rehabilitation Medicine Physician 2081P0010X 036-102847 IL Primary

Addresses

Primary practice location

2211 N Oak Park Ave
Chicago, IL 60707-3392

Mailing address

PO Box 8500
Philadelphia, PA 19178-8500
Phone (773) 385-5463

Other practice location 1

355 E Erie St
Chicago, IL 60611-3167
Phone (312) 238-1000

Other practice location 2

4400 W 95th St Ste 306
Oak Lawn, IL 60453-2659
Phone (708) 684-5428

Other practice location 3

1801 W Taylor St
Chicago, IL 60612-4795
Phone (312) 996-7416

Other identifiers 3

IdentifierTypeStateIssuer
036102847MedicaidIL
036102847-2MedicaidIL
036102847-3MedicaidIL

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address SMUKHERJEE163412@DIRECT.LUHS.ORG Direct LOYOLA UNIVERSITY MEDICAL CENTER
Direct Messaging Address smukherjee409531@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040421000752 IL Practitioner - Physical Medicine and RehabilitationPractitioner - Pediatric Medicine 3870589351 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pediatric Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-102847ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Aug 18, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Apr 6, 2024 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Shriners Hospitals for Children CurrentSince Jun 1, 2020 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Apr 6, 2024 Accepting new patients
Shriners Hospitals for Children CurrentSince Jun 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Pediatrics CurrentSince Feb 1, 2025 Accepting new patients
Loyola University Medical Center CurrentSince Aug 18, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Board of Trustees of the University of Illinois Pediatrics Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

29373 Network Pl
Chicago, IL 60673

1855 W Taylor St
#648
Chicago, IL 60612
Phone (312) 996-6582

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

4400 W 95th St
Ste 306
Oak Lawn, IL 60453
Phone (708) 684-5428

Interoperability endpoints

  • Direct secure messaging: smukherjee118186@uihealth.direct-ci.com
  • Direct secure messaging: smukherjee409531@direct.myadvocateaurora.org

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1790770659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788500",
            "telephone_number": "773-385-5463",
            "fax_number": "773-385-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073392",
            "telephone_number": "773-385-5463",
            "fax_number": "773-385-5488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 E Erie St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113167",
            "country_code": "US",
            "telephone_number": "312-238-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4400 W 95th St Ste 306",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532659",
            "country_code": "US",
            "telephone_number": "708-684-5428",
            "fax_number": "708-684-2079",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-996-7416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKHERJEE",
        "first_name": "SHUBHRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-102847",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-102847",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "IL",
            "license": "036-102847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102847",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102847-2",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036102847-3",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SMUKHERJEE163412@DIRECT.LUHS.ORG",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smukherjee409531@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4400 W 95th St Ste 306",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4400 W 95th St Ste 306",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.