Physician Compare National (NPI:1447363585)

HEALTHCARE PROVIDER: SHAWN E BAILEY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1447363585
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365530219
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090625000330
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAILEY
	Individual professional last name
Provider First Name	SHAWN
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	EPSS NORTH REGION LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0345582474
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	600 E 1ST ST
	Group Practice or individual's line 1 address
City	SPRING VALLEY
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	613621512
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8156645311
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140143
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARGARETS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	141337
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PERRY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140234
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ILLINOIS VALLEY COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140067
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	OSF SAINT FRANCIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y