DR. JEFFREY SHANES (NPI# 1740236835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740236835 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY SHANES |
| Credential | M.D. |
| Practice Address |
675 W North Ave Suite-210 Melrose Park IL 60160-1634 |
| Practice Telephone | 7088381448 |
| Practice Fax Number | 7083440508 |
| Mailing Telephone | 7088381448 |
| Mailing Fax Number | 7083440508 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2019-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 036-064782 | IL | Other Service Providers |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
036-064782 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | GROUP NPI NUMBER FOR CONSULTANTS IN CARDIOVASCULAR MEDICINE S C | 1164530713 | 01 |
| IL | BLUECROSS BLUE SHIELD GROUP PROVIDER NUMBER | 31602469 | 01 |
| IL | MEDICARE PTAN NUMBER | L18915 | 01 |
| IL | RAILROAD MEDICARE INDIVIDUAL PROVIDER ID NUMBER | 110032830 | 01 |
| IL | MEDICARE GROUP PTAN FOR LOCALITY 015 | 216577 | 01 |
| IL | 036-064782 | 05 | |
| IL | MEDICARE INDIVIDUAL PTAN FOR LOALITY 015 | K51366 | 01 |
| IL | MEDICARE GROUP NUMBER | 209712 | 01 |
| IL | MEDICARE GROUP NUMBER FOR CONSULTANTS IN CARDIOVASCULAR MEDICINE | 961280 | 01 |
| IL | RAILROAD MEDICARE GROUP PTAN NUMBER | CC1592 | 01 |
| Street Address |
675 W NORTH AVE SUITE-210 |
| City | MELROSE PARK |
| State | IL |
| Zip Code | 60160-1634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134727 | Brad Anstadt | Ophthalmology | 675 W North Ave, Ste 107, Melrose Park, IL 60160-1622 | 2005-06-20 |
| 1578920484 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 675 W North Ave, Melrose Park, IL 60160-1634 | 2016-01-22 |
| 1356733034 | Jessica Lynn Dye | Physician Assistant | 675 W North Ave, Suite 607, Melrose Park, IL 60160-1634 | 2015-03-04 |
| 1861893463 | Paige D Formsma | Audiologist | 675 W North Ave, Suite 110, Melrose Park, IL 60160-1634 | 2014-09-15 |
| 1083014047 | Jennifer Morales | Psychologist | 675 W North Ave, Ste 306, Melrose Park, IL 60160-1634 | 2014-08-27 |
| 1538577754 | Elizabeth Bojarskyj | Pharmacist | 675 W North Ave, Melrose Park, IL 60160-1634 | 2014-07-31 |
| 1780091538 | Bryan David Erce | Dentist | 675 W North Ave, Suite 307, Melrose Park, IL 60160-1634 | 2014-07-14 |
| 1740619246 | Merissa Mann | Physician Assistant | 675 W North Ave, Suite 402, Melrose Park, IL 60160-1634 | 2013-11-05 |
| 1770916074 | Yonatan Rosenblum | Psychologist | 675 W North Ave, Suite 306, Melrose Park, IL 60160-1634 | 2013-08-10 |
| 1538509666 | Hai Solomon M.d.s.c. | Obstetrics & Gynecology | 675 W North Ave, Suite 512, Melrose Park, IL 60160-1634 | 2013-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
| 1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
| 1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
| 1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
| 1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
| 1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
| 1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
| 1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
| 1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
| 1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
| Find all providers in zip 60160 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164984514 | Cil Care of Il II, LLC | Internal Medicine | 1900 E Golf Rd Ste 950, Schaumburg, IL 60173-5034 | 2019-04-04 |
| 1467950733 | Coordinated Health of Il, LLC | Internal Medicine | 1900 E Golf Rd Ste 950c, Schaumburg, IL 60173-5834 | 2018-01-31 |
| 1740728039 | Jenna Schrage | Internal Medicine | 317 N 5th St, Springfield, IL 62701-1003 | 2017-02-07 |
| 1417373010 | Hashim Gazi | Internal Medicine | 3331 West Deyoung, Suite 100, Marion, IL 62959 | 2014-03-07 |
| 1992041644 | Daniel Brent Nelson | Internal Medicine | 3810 Farhills Dr, Champaign, IL 61822-9321 | 2012-12-28 |
| 1801184767 | Surya Teja Chaturvedula | Internal Medicine | 5409 N Knoxville Ave Ste 207, Peoria, IL 61614-5069 | 2011-07-13 |
| 1841583952 | C Dean Katsamakis Do Facc Sc | Internal Medicine | 240 Waukegan Rd, Glenview, IL 60025-5159 | 2011-05-23 |
| 1154550119 | Elliott M Groves | Internal Medicine | 840 S Wood St Ste Smc715, Chicago, IL 60612-4325 | 2009-07-10 |
| 1841484813 | Elsayed Mohamed | Internal Medicine | 804 E Woodfield Rd Ste 300, Schaumburg, IL 60173-4776 | 2007-08-31 |
| 1952513335 | Muhammad Sikander Akbar | Internal Medicine | 6300 N Lincoln Ave, Chicago, IL 60659-1204 | 2007-05-05 |
| Find all providers with the same taxonomy | ||||
| City | MELROSE PARK |
| Zip Code | 60160 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.