Active NPI
Shanna Jones
- Physical Therapist
- Chicago, IL
National Provider Identifier
1811445562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-022375
- Practice address
- 111 N Canal St Ste LNW 2
Chicago, IL 60606-7218 - Phone
- (312) 414-1975
- Fax
- (312) 414-1979
- NPI assigned
- Sep 12, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-022375 | IL | Primary |
Addresses
Primary practice location
111 N Canal St Ste LNW 2
Chicago, IL 60606-7218
Mailing address
900 Rand Rd
Suite 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976
Other names 1
- Shanna Polka
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-022375 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epicore Physical Therapy | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Orthopedic Physical Therapist
- Chicago, IL
- NPI 1902416720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1811445562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 RAND RD",
"address_2": "SUITE 300",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600162359",
"telephone_number": "847-324-3976",
"fax_number": "847-929-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N CANAL ST STE LNW 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606067218",
"telephone_number": "312-414-1975",
"fax_number": "312-414-1979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "SHANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-12",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-022375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNA",
"last_name": "POLKA",
"code": "1",
"type": "Former Name"
}
]
}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 Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.