Sherry Shibu, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125.083400 Issued in IL

Practice address

3231 Euclid Ave FL 5
Berwyn, IL 60402-3466

Phone

(877) 834-7264

NPI assigned

Mar 19, 2024

Last updated

May 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1861252942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE FL 5",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023466",
            "telephone_number": "877-834-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE FL 5",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023466",
            "telephone_number": "877-834-7264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBU",
        "first_name": "SHERRY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.083400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Shanklin
• Jeffrey Shapiro
• Steven James Sharp, M.D.
• Candice Sherlock, RDH
• Dawn Sherwood, L.S.W.
• Lemin Kimmy Shimada, CRNA
• Lukasz J Sidorowicz
• Maya Siegel
• Ana Elizabeth Sierra, MA
• Angel Sifuentes, LSW

• Family Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.