STACEY A SHAW
NPI 1356973762
Nurse Practitioner - Pediatrics in Chicago, IL

Q: What is Stacey Shaw's NPI number?

The NPI number for Stacey Shaw is 1356973762. It was assigned to this individual provider in the NPPES registry on February 4, 2020.

Q: What is Stacey Shaw's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Shaw was last updated on October 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 04, 2020PECOS Enrolled

5841 S MARYLAND AVE, CHICAGO, IL 60637(888) 824-0200 Get Directions Write a Review

NPPES record last updated: October 24, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Oct 24, 2022, May 19, 2022, Apr 18, 2022 and 2 more (5 updates tracked since 2020).

On this page

About Stacey A Shaw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY A SHAW (NPI 1356973762) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (209019812) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1356973762

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameSTACEY A SHAW

Location Address5841 S MARYLAND AVEChicago, IL 60637-1443

Mailing Address150 Harvester Dr, Suite 300Burr Ridge, IL 60527-5919

Phone(888) 824-0200

Sole ProprietorNo

Enumeration DateFebruary 4, 2020

Last NPPES UpdateOctober 24, 20225 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2020

✔ NPI 1356973762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in IL · 209019812

5841 S MARYLAND AVE, Chicago, IL 60637

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey A Shaw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60637 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DON MARTINEZ M.D.

Radiology (Diagnostic Radiology)