DR. MRINALI SHETTY (NPI# 1285178046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285178046 |
| Entity Type | Individual |
| Full Name | DR. MRINALI SHETTY |
| Credential | M.D. |
| Practice Address |
2650 Ridge Ave Ste 1304 Evanston IL 60201 |
| Mailing Address |
180 Harvester Dr Ste 110 Burr Ridge IL 60527-6686 |
| Practice Telephone | 8475701485 |
| Mailing Telephone | 7370211507 |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2019-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
125073466 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
125.073466 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2650 Ridge Ave Ste 1304, Evanston, IL 60201 | 8475701485 |
| Street Address |
2650 RIDGE AVE STE 1304 |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649535782 | John Warren Ebersole | Radiology | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1718 | 2012-07-04 |
| 1750907648 | Ayshah Mahmud | Dentist | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-06-17 |
| 1831714740 | Corey Rollor | Dentist | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-06-16 |
| 1821613407 | Patrick Mulligan | Internal Medicine | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-06-10 |
| 1376166546 | Ann Kim | Family Medicine | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-05-22 |
| 1396368759 | Tyler Williams | Family Medicine | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-05-20 |
| 1679195259 | Sariya Ali Siddiqui | Student in an Organized Health Care Education/Training Program | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-05-18 |
| 1508488438 | Mahnoor Asghar | Student in an Organized Health Care Education/Training Program | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-05-14 |
| 1275155442 | Anu Pandit | Student in an Organized Health Care Education/Training Program | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-05-11 |
| 1992327209 | Robert Terry Toelke | Pathology | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2020-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| Find all providers in zip 60201 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306296074 | Safwan Gaznabi | Internal Medicine | Northshore University Healthsystem, Office of Academic Affairs 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2016-06-14 |
| 1184853558 | Michael Boehmer Pine | Internal Medicine | 1210 Chicago Ave, Ste 503, Evanston, IL 60202-6515 | 2009-07-07 |
| 1720042419 | Cardiovascular Associates of Glenbrook & Evanston LLC | Internal Medicine | 1713 Central, Evanston, IL 60201 | 2006-04-12 |
| 1851368328 | Richard D Stagl | Internal Medicine | 1713 Central St, Evanston, IL 60201 | 2006-03-03 |
| 1548245335 | Ira William Weiss | Internal Medicine | 2650 Ridge Ave Rm G234, Evanston Hospital Cardiac Graphics Dept, Evanston, IL 60201-1718 | 2005-12-14 |
| 1669476545 | Steven C Smart | Internal Medicine | 2650 Ridge Ave, Evanston, IL 60201-1718 | 2005-06-09 |
| 1477904829 | Kaveh Rezaei Bookani | Internal Medicine | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1700 | 2016-06-28 |
| 1841605177 | Oscar Javier Garza Ovalle | Internal Medicine | 2650 Ridge Ave Ste 1304, Evanston, IL 60201-1718 | 2014-06-25 |
| 1215349162 | Marianna Sargsyan | Internal Medicine | 355 Ridge Ave, Evanston, IL 60202-3328 | 2014-05-27 |
| 1104069608 | Rupa Krishnaswamy Patil | Internal Medicine | 1000 Central St Ste 730, Evanston, IL 60201 | 2009-04-13 |
| Find all providers in EVANSTON | ||||
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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.