Shelly Lynne Bledsoe, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Practice address

2306 E 75TH St
Chicago, IL 60649-3306

Phone

(773) 731-0014

Fax

(773) 731-2034

NPI assigned

Jul 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: shellybledsoe@jph.medalliesdirect.net

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.

• Jackson Park Hospital Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497750699
  NPD
• Cardiothoracic & Vascular Surgical Associates S C

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Oak Lawn, IL
  • NPI 1780679407

  Vascular Surgery

  NPD (past)

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821098542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 MERRY LN",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231420",
            "telephone_number": "630-586-9930",
            "fax_number": "630-530-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 E 75TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493306",
            "telephone_number": "773-731-0014",
            "fax_number": "773-731-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "SHELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BLC-Kenwood of Lake View, LLC
• BLC-the Hallmark, LLC
• Thomas P Bleck, MD
• Courtney Bledsoe, L.C.S.W.
• Jeanette Nadene Bledsoe
• Kathleen S. Blehart, PSYD
• Omar A. Bleibel, DC
• Alexander Safier Bleiberg
• Edward Bleier, MD
• Pierre Renaud Blemur Jr., M.D.

• All providers in Chicago, IL
• Vascular Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.