Individual provider Active NPI

Allan J Shoelson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1790805323
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016003603 Issued in IL
Practice address
1611 W Harrison Street
Suite 510
Chicago, IL 60612
Phone
(312) 563-2800
Fax
(312) 563-2075
NPI assigned
Mar 29, 2007
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016003603 IL Primary

Addresses

Primary practice location

1611 W Harrison Street
Suite 510
Chicago, IL 60612

Mailing address

1611 W Harrison Street
Suite 510
Chicago, IL 60612
Phone (312) 563-2800

Other identifiers 1

IdentifierTypeStateIssuer
1632253OtherILBCBS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101216001000 IL Practitioner - Podiatry 5698963684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1611 W Harrison St
Suite 510
Chicago, IL 60612-4861
Phone (312) 563-2800

Rush University Medical Ctr Orthopedic Buildin
1611 West Harrison Street Suite 510
Chicago, IL 60612-4861

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016003603ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Allan J Shoelson, DPM, PC Foot & Ankle Surgery CurrentSince May 17, 2010 Accepting new patients

Locations

1611 W Harrison St
Ste 510
Chicago, IL 60612
Phone (312) 563-2800

Interoperability endpoints

  • Direct secure messaging: ashoelson2832@direct.rush.rush-health.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1790805323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON STREET",
            "address_2": "SUITE 510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-563-2800",
            "fax_number": "312-563-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON STREET",
            "address_2": "SUITE 510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-563-2800",
            "fax_number": "312-563-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOELSON",
        "first_name": "ALLAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016003603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1632253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.