Active NPI
Jean Shlyak, M.D.
- Internal Medicine Physician
- Northbrook, IL
National Provider Identifier
1851457717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036064733
- Practice address
- 3000 Dundee Rd Ste 215
Northbrook, IL 60062-2432 - Phone
- (847) 390-8550
- Fax
- (847) 390-9095
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036064733 | IL | Primary |
Addresses
Primary practice location
3000 Dundee Rd Ste 215
Northbrook, IL 60062-2432
Mailing address
3000 Dundee Rd Ste 215
Northbrook, IL 60062-2432
Phone (847) 390-8550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036064733 | Medicaid | IL | |
| 31620794 | Other | IL | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|---|
| I20110307000462 | IL | Practitioner - Internal Medicine | 8921280330 | Practice locations: Northbrook, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
3000 Dundee Rd
Suite 215
Northbrook, IL 60062-2432
Phone (847) 390-8550
Hospital & facility affiliations
- Progressive Home Health Care
- Northshore University Healthsystem - Evanston Hospital
- Advocate Lutheran General Hospital
- Northwest Community Hospital 1
- Advocate Condell Medical Center
- Northwestern Lake Forest Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036064733 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jean Shlyak MD PC | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- jean.shlyak.1@30237.direct.athenahealth.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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Northbrook, IL
- NPI 1235431305
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Libertyville, IL
- NPI 1124272547
-
- Mobile Mammography Clinic/Center
- Grayslake, IL
- NPI 1770737199
Hospital
-
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1578932869
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1770531600
-
- General Acute Care Hospital
- Lake Forest, IL
- NPI 1124025176
-
- Home Health Agency
- Northbrook, IL
- NPI 1972533966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302048000000",
"number": "1851457717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3000 DUNDEE RD STE 215",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622432",
"telephone_number": "847-390-8550",
"fax_number": "847-390-9095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 DUNDEE RD STE 215",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600622432",
"telephone_number": "847-390-8550",
"fax_number": "847-390-9095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHLYAK",
"first_name": "JEAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2011-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036064733",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036064733",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "31620794",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.