Individual provider Active NPI

Shelly Verma, D.O

  • Family Medicine Physician
  • Park Ridge, IL
National Provider Identifier
1912325796
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036143774 Issued in IL
Practice address
1610 Luther LN
Park Ridge, IL 60068-1243
Phone
(847) 318-2303
Fax
(847) 318-2377
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO00978 RI
Hospitalist Physician 208M00000X 036143774 IL
Family Medicine Physician 207Q00000X 036143774 IL Primary

Addresses

Primary practice location

1610 Luther LN
Park Ridge, IL 60068-1243

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone (847) 318-6920

Other practice location 2

1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6920

Other practice location 3

1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6920

Other practice location 4

7505 Grand Ave
Gurnee, IL 60031
Phone (847) 265-4800

Other practice location 5

7505 Grand Ave
Gurnee, IL 60031
Phone (847) 265-4800

Other practice location 6

7505 Grand Ave
Gurnee, IL 60031
Phone (847) 265-4800

Other practice location 7

1285 Hartrey Ave
Evanston, IL 60202-1056
Phone (847) 666-3494

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address sverma196902@direct.myadvocateaurora.org Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180207001040 IL Practitioner - Family Practice 4385949841 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 W 162ND St
Advocate Med GRP S Holland
South Holland, IL 60473-2003
Phone (708) 730-2200

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone (847) 318-9368

1775 Dempster St
Park Ridge, IL 60068-1143

1775 W Ballard Rd
Geriatrics
Park Ridge, IL 60068-1005
Phone (847) 318-2500

1999 Dempster St
Park Ridge, IL 60068-1156
Phone (847) 318-2303

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036143774ILMDFamily Medicine Physician
DO00978RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Oct 28, 2021 Accepting new patients
Erie Family Health Center Inc. CurrentSince Feb 7, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 10, 2025 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Amg Illinois LTD Family Medicine CurrentSince Feb 19, 2018 Accepting new patients
Erie Family Health Center Inc CurrentSince Feb 7, 2022 Accepting new patients
Amg Illinois LTD CurrentSince Feb 19, 2018 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jan 10, 2025 Accepting new patients
Endeavor Health Medical Group Emergency Medicine Current Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

1504 S Albany Ave
Chicago, IL 60623

9532 Eagle Way
Chicago, IL 60678

29373 Network Pl
Chicago, IL 60673

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

1285 Hartrey Ave
Evanston, IL 60202
Phone (847) 666-2302

7505 Grand Ave
Gurnee, IL 60031
Phone (847) 245-8448

45 Tower Ct
Gurnee, IL 60031
Phone (847) 623-3200

1610 Luther Ln
Park Ridge, IL 60068
Phone (847) 318-2303

1775 Ballard Rd
Park Ridge, IL 60068
Phone (847) 318-6020

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Interoperability endpoints

  • Direct secure messaging: sverma196902@direct.myadvocateaurora.org
  • Direct secure messaging: sverma523502@direct.ochin.org

Organizations & group practices 10

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1912325796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 LUTHER LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681243",
            "telephone_number": "847-318-2303",
            "fax_number": "847-318-2377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Ballard Rd",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681005",
            "country_code": "US",
            "telephone_number": "847-318-6920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Ballard Rd",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "60068",
            "country_code": "US",
            "telephone_number": "847-318-6920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Ballard Rd",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "60068",
            "country_code": "US",
            "telephone_number": "847-318-6920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7505 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "60031",
            "country_code": "US",
            "telephone_number": "847-265-4800",
            "fax_number": "847-245-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7505 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "60031",
            "country_code": "US",
            "telephone_number": "847-265-4800",
            "fax_number": "847-245-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7505 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "60031",
            "country_code": "US",
            "telephone_number": "847-265-4800",
            "fax_number": "847-245-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1285 Hartrey Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602021056",
            "country_code": "US",
            "telephone_number": "847-666-3494",
            "fax_number": "847-868-8964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERMA",
        "first_name": "SHELLY",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00978",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036143774",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036143774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1610 Luther Ln",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sverma196902@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1610 Luther Ln",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.