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  7. NPI Record 1790805323

DR. ALLAN J SHOELSON DPM
Complete NPI Record 1790805323
Podiatrist - Foot & Ankle Surgery in Chicago, IL

NPI Status: Active since March 29, 2007

Contact Information

1611 W HARRISON STREET
SUITE 510
CHICAGO, IL
ZIP 60612
Phone: (312) 563-2800
Fax: (312) 563-2075

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Second Line Business Mailing Address
  10. Provider Business Mailing Address City Name
  11. Provider Business Mailing Address State Name
  12. Provider Business Mailing Address Postal Code
  13. Provider Business Mailing Address Country Code If outside U S
  14. Provider Business Mailing Address Telephone Number
  15. Provider Business Mailing Address Fax Number
  16. Provider First Line Business Practice Location Address
  17. Provider Second Line Business Practice Location Address
  18. Provider Business Practice Location Address City Name
  19. Provider Business Practice Location Address State Name
  20. Provider Business Practice Location Address Postal Code
  21. Provider Business Practice Location Address Country Code If outside U S
  22. Provider Business Practice Location Address Telephone Number
  23. Provider Business Practice Location Address Fax Number
  24. Provider Enumeration Date
  25. Last Update Date
  26. Provider Gender Code
  27. Healthcare Provider Taxonomy Code 1
  28. Provider License Number 1
  29. Provider License Number State Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Other Provider Identifier 1
  32. Other Provider Identifier Type Code 1
  33. Other Provider Identifier State 1
  34. Other Provider Identifier Issuer 1
  35. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1790805323. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1790805323
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: ALLAN
The first name of the provider, if the provider is an individual.
Provider Middle Name: J
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The State code in the location of the provider being identified.
Provider Credential Text: DPM
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider First Line Business Mailing Address: 1611 W HARRISON STREET
The country code in the location address of the provider being identified.
Provider Second Line Business Mailing Address: SUITE 510
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address City Name: CHICAGO
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: IL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 60612
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address Country Code If outside U S : US
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Business Mailing Address Telephone Number: 3125632800
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3125632075
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 1611 W HARRISON STREET
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 510
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CHICAGO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: IL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 60612
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3125632800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3125632075
The city name in the location address of the provider being identified.
Provider Enumeration Date: 3/29/2007
The State code in the location of the provider being identified.
Last Update Date: 7/6/2010
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Gender Code: M
The country code in the location address of the provider being identified.
Healthcare Provider Taxonomy Code 1: 213ES0103X
The telephone number associated with the location address of the provider being identified.
Provider License Number 1: 016003603
The fax number associated with the location address of the provider being identified.
Provider License Number State Code 1: IL
The date that a record was last updated or changed.
Healthcare Provider Primary Taxonomy Switch 1: Y
The date that a record was last updated or changed.
Other Provider Identifier 1: 1632253
The code designating the provider’s gender if the provider is a person.
Other Provider Identifier Type Code 1: 01
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Other Provider Identifier State 1: IL
Other Provider Identifier Issuer 1: BCBS
Is Sole Proprietor: N