Individual provider Active NPI

Shana Elisha Ross, D.O.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1982022851
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.142592 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.142592 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

808 S Wood St
469 Cme, M/C 724
Chicago, IL 60612
Phone (303) 709-5325

Other names 1

  • Shana Elisha Nelson Former name

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
I20170927000036 IL Practitioner - Emergency Medicine 7719296995 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

808 S Wood St
722 Uic Emergency Medicine
Chicago, IL 60612-7300
Phone (312) 355-0865

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142592ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Sep 19, 2017 Accepting new patients
Board of Trustees of the University of Illinois Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 1, 2017 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Sep 19, 2017 Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 1, 2021 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

808 S Wood St
#469
Chicago, IL 60612
Phone (312) 413-7492

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

808 S Wood St
#722
Chicago, IL 60612
Phone (312) 355-0865

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Interoperability endpoints

  • Direct secure messaging: sross17421@uihealth.direct-ci.com

Organizations & group practices 7

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 1

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1982022851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S WOOD ST",
            "address_2": "469 CME, M/C 724",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "303-709-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SHANA",
        "middle_name": "ELISHA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.142592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "NELSON",
            "middle_name": "ELISHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.