Inbo Shim

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036.123702 Issued in IL

Practice address

5841 S Maryland Ave # J517
Chicago, IL 60637-1447

Phone

(917) 470-4254

NPI assigned

Jun 24, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1790913093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PARK AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603052038",
            "telephone_number": "917-470-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # J517",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "917-470-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "INBO",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.123702",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "IL",
            "license": "036123702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Michael Shilney, LCPC
• Shiloh Ambulance and Medivan Services Inc
• Shilohs Village
• Jay L Shils, PHD
• Hyunji Shim, MD
• Ji Hyun Shim
• Ki Casey Shim, MD
• Kyungran Shim, M.D.
• Sofia Elsa Shim, PHARMD
• Carolyn Shima

• Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.

Verify at the official NPI Registry.