Active NPI
Shun Tanaka
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Chicago, IL
National Provider Identifier
1811713985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 125087103
- Practice address
- 5841 S. Maryland Ave. M/C 5040
Chicago, IL 60637-1443 - Phone
- (773) 702-2500
- NPI assigned
- Nov 22, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 125087103 | IL | Primary |
Addresses
Primary practice location
5841 S. Maryland Ave. M/C 5040
Chicago, IL 60637-1443
Mailing address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260312002655 | IL | Order and Referring Only - Cardiac Surgery | 0042793549 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125087103 | IL | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1811713985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 HARVESTER DR STE 110",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276686",
"telephone_number": "773-702-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S. MARYLAND AVE. M/C 5040",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371443",
"telephone_number": "773-702-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAKA",
"first_name": "SHUN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-22",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "IL",
"license": "125087103",
"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 Feb 23, 2026; 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.