VIDYA SHANKARAN (NPI# 1528214624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528214624 |
| Entity Type | Individual |
| Full Name | VIDYA SHANKARAN |
| Credential | MD |
| Practice Address |
340 W Lincoln St Ste 500 Belleville IL 62220-1900 |
| Practice Telephone | 6182777400 |
| Mailing Telephone | 6182777400 |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | 20106 | NH | Allopathic & Osteopathic Physicians |
| Y | 208200000X | Plastic Surgery | 036134925 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 125050724 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS DEPT OF FINANCIAL AND PROFESSIONAL REGULATION | 036134925 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Medical Center Dr, Lebanon, NH 037560001 | 6036505148 |
| Street Address |
340 W LINCOLN ST STE 500 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477558922 | John A. Hucker | Obstetrics & Gynecology | 340 W Lincoln St, Ste 560, Belleville, IL 62220-1900 | 2005-06-20 |
| 1609313758 | Marianne Guthrie | Nurse Practitioner | 340 W Lincoln St, 200, Belleville, IL 62220-1900 | 2017-01-27 |
| 1841683133 | Kathryn Liermann | Physician Assistant | 340 W Lincoln St, Suite 540, Belleville, IL 62220-1900 | 2015-03-10 |
| 1447686886 | Amelia Gerke | Physician Assistant | 340 W Lincoln St, Suite 540, Belleville, IL 62220-1900 | 2013-09-17 |
| 1811286305 | Sherry Tindall | Nurse Practitioner | 340 W Lincoln St, Suite 400, Belleville, IL 62220-1900 | 2011-04-05 |
| 1427204965 | Elizabeth Renaker-jansen | Plastic Surgery | 340 W Lincoln St, Suite 500, Belleville, IL 62220-1900 | 2008-08-15 |
| 1811188949 | Kristina Naseer | Anesthesiology | 340 W Lincoln St, Suite 200, Belleville, IL 62220-1900 | 2007-08-05 |
| 1154538064 | Desiree Y Miller | Physician Assistant | 340 W Lincoln St, Suite#300, Belleville, IL 62220-1900 | 2007-05-17 |
| 1700962271 | Lincoln Surgical Group | Surgery | 340 W Lincoln St, Suite 500, Belleville, IL 62220-1900 | 2006-10-27 |
| 1487755518 | Girish R Mood | Internal Medicine | 340 W Lincoln St, Suite 400, Belleville, IL 62220-1900 | 2006-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427204965 | Elizabeth Renaker-jansen | Plastic Surgery | 340 W Lincoln St, Suite 500, Belleville, IL 62220-1900 | 2008-08-15 |
| 1558556878 | St. Elizabeth's Hospital | Plastic Surgery | 2900 Frank Scott Pkwy W, Suite 970, Belleville, IL 62223-5000 | 2007-09-10 |
| 1578551065 | Plastic Surgery Consultants, P.C. | Plastic Surgery | 4600 Memorial Dr, Medical Office Building 2 - Suite 320, Belleville, IL 62226-5366 | 2005-10-10 |
| 1548258288 | Robert C. Wanless | Plastic Surgery | 4600 Memorial Dr, Suite 320, Belleville, IL 62226-5366 | 2005-10-06 |
| 1215922067 | Richard J. Hehmann | Plastic Surgery | 4600 Memorial Dr, Suite 320, Belleville, IL 62226-5366 | 2005-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093363236 | Stephen A Madry Md | Plastic Surgery | 27750 W Il Route 22 Ste 230, Barrington, IL 60010-1924 | 2019-08-30 |
| 1588129928 | Rosett Plastic Surgery, LLC | Plastic Surgery | 1149 Crofton Ave N, Highland Park, IL 60035-3953 | 2019-02-08 |
| 1922572411 | Plastic Surgery Services and Equipment LLC | Plastic Surgery | 3050 Finley Rd Ste 300b, Downers Grove, IL 60515-1369 | 2019-01-17 |
| 1710487095 | Bradley Ashpole Md LLC | Plastic Surgery | 501 W Golf Rd Ste A, Schaumburg, IL 60195-3502 | 2018-02-13 |
| 1821501586 | Plastic Surgery Clinic of Chicago LLC | Plastic Surgery | 850 S Wabash Ave Ste 310, Chicago, IL 60605-3642 | 2017-11-15 |
| 1720500085 | Warner Aesthetic & Reconstructive Institute | Plastic Surgery | 570 Lincoln Ave Lowr Level4, Winnetka, IL 60093-2355 | 2017-07-08 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1073977369 | Subramaniam Arumugam | Plastic Surgery | 13020 S Winnebago Rd, Palos Heights, IL 60463-2056 | 2016-04-12 |
| 1598123424 | Craig Bradley | Plastic Surgery | 1035 W Rundell Pl, Chicago, IL 60607-2514 | 2016-02-06 |
| 1215346325 | Damian Gress | Plastic Surgery | 943 W 14th Pl, Unit 2 B, Chicago, IL 60608-2287 | 2014-08-04 |
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| City | BELLEVILLE |
| Zip Code | 62220 |
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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.