Individual provider Active NPI

Shellee A Grim, PHARM.D.

  • Pharmacotherapy Pharmacist
  • Chicago, IL
National Provider Identifier
1912084351
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
051.289617 Issued in IL
Practice address
1740 W Taylor St
Room C300
Chicago, IL 60612-7232
Phone
(312) 996-3663
Fax
(312) 413-4146
NPI assigned
Nov 1, 2006
Last updated
Oct 6, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 012149 KY
Pharmacist 183500000X PH00040273 WA
Pharmacotherapy Pharmacist 1835P1200X 051.289617 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Room C300
Chicago, IL 60612-7232

Mailing address

833 S Wood St
Room 164 MC 886
Chicago, IL 60612-7229
Phone (312) 996-0870

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
012149KYMDPharmacist
PH00040273WAMDPharmacist
051.289617ILMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1912084351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 S WOOD ST",
            "address_2": "ROOM 164 MC 886",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127229",
            "telephone_number": "312-996-0870",
            "fax_number": "312-996-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "ROOM C300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-3663",
            "fax_number": "312-413-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIM",
        "first_name": "SHELLEE",
        "middle_name": "A",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "012149",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00040273",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IL",
            "license": "051.289617",
            "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 Oct 6, 2008; 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.