DR. SHIVA PRASAD SHASHIDHARAN (NPI# 1588911333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588911333 |
| Entity Type | Individual |
| Full Name | DR. SHIVA PRASAD SHASHIDHARAN |
| Credential | MD |
| Practice Address |
500 N Wall St Kankakee IL 60901 |
| Mailing Address |
500 N Wall St Kankakee IL 60901-2942 |
| Practice Telephone | 8444044787 |
| Practice Fax Number | 8159363243 |
| Mailing Telephone | 8444044787 |
| Mailing Fax Number | 8159363243 |
| Enumeration Date | 2012-08-11 |
| Last Update Date | 2018-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036137703 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5700 Centre Ave, Apt 1001, Pittsburgh, PA 152063743 | 3472654169 |
| Street Address |
500 N WALL ST |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649265026 | Lambros C Chrones | Psychiatry & Neurology | 500 N Wall St, Suite 200, Kankakee, IL 60901-2942 | 2005-09-13 |
| 1477062172 | Cheryl D Rogers | Nurse Practitioner | 500 N Wall St, Kankakee, IL 60901-2942 | 2017-09-25 |
| 1124546221 | Andrew J Donofrio | Physician Assistant | 500 N Wall St, Kankakee, IL 60901-2942 | 2017-09-08 |
| 1245758416 | Elizabeth Ann Wirth | Clinical Nurse Specialist | 500 N Wall St, Kankakee, IL 60901-2942 | 2017-09-07 |
| 1568708667 | Karla Schweigert | Nurse Practitioner | 500 N Wall St, Kankakee, IL 60901-2942 | 2012-12-17 |
| 1295964872 | Amit Zachariah | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2009-07-05 |
| 1992959555 | Dawit Amare | Psychiatry & Neurology | 500 N Wall St, Ste. 200, Kankakee, IL 60901-2942 | 2008-11-10 |
| 1376709758 | Nha T Huynh | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2008-08-05 |
| 1316111693 | Alaa E Abdel-meguid, M.d., S.c. | Internal Medicine | 500 N Wall St, Suite 501, Kankakee, IL 60901-2942 | 2008-04-17 |
| 1336339381 | Abhimanyu Beri | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2007-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| 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 |
|---|---|---|---|---|
| 1124314349 | Gaurang Gujarathi | Internal Medicine | 1710 W Court St, Kankakee, IL 60901 | 2011-06-27 |
| 1487679205 | Vijay M Haryani | Internal Medicine | 500 N Wall St Ste C100, Kankakee, IL 60901-2942 | 2006-07-13 |
| 1316289077 | Tarun Jain | Internal Medicine | 500 N Wall St Ste C100, Kankakee, IL 60901-2942 | 2013-03-20 |
| 1336339381 | Abhimanyu Beri | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2007-07-26 |
| 1447454657 | Advanced Cardiovascular Services | Internal Medicine | 455 W. Court St., Suite 202, Kankakee, IL 60441 | 2007-06-12 |
| 1881729853 | Philip G Hays Md Sc | Internal Medicine | 400 N Wall St Ste 303, Kankakee, IL 60901-2964 | 2007-02-22 |
| 1013099225 | Vijay M. Haryani, Md, Sc | Internal Medicine | 375 N Wall St, Suite 310, Kankakee, IL 60901-3483 | 2006-10-19 |
| 1275540536 | Philip G Hays | Internal Medicine | 400 N Wall St Ste 303, Kankakee, IL 60901-2964 | 2006-08-01 |
| 1013962182 | Lynn G Brown | Internal Medicine | 500 N Wall St, Kankakee, IL 60901-2942 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528596350 | Stat Cardiologist Inc | Internal Medicine | 2425 W 22nd St Ste 209, Oak Brook, IL 60523-4655 | 2017-05-24 |
| 1306296074 | Safwan Gaznabi | Internal Medicine | Northshore University Healthsystem, Office of Academic Affairs 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2016-06-14 |
| 1154796290 | Ray Jean Pensinger | Internal Medicine | 105 S. Fleming Rd., Woodstock, IL 60098-7903 | 2015-12-01 |
| 1073905311 | Cardio Medical Center Sc | Internal Medicine | 7746 West Madison Ave, Forrest Park, IL 60131 | 2015-02-24 |
| 1427457399 | Charles Joseph Frahm | Internal Medicine | 1200 E Madison Park, Chicago, IL 60615-2961 | 2014-08-17 |
| 1225447725 | Jeremy R. Estrada | Internal Medicine | 5841 S Maryland Ave # Mc5841, Chicago, IL 60637-1447 | 2014-08-08 |
| 1285049197 | Nidhi Madan | Internal Medicine | 1717 W Congress Pkwy Ste 317, Chicago, IL 60612 | 2014-06-30 |
| 1295159184 | Ca Group, LLC | Internal Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2014-02-12 |
| 1457788424 | Chicago Vascular Clinic Ltd | Internal Medicine | 812 E Woodfield Rd, Schaumburg, IL 60173-4714 | 2013-10-04 |
| 1942634688 | Vein Md Consultants, LLC | Internal Medicine | 1865 N. Eltnor Blvd., West Chicago, IL 60185-5900 | 2013-08-29 |
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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.