Physician Compare National (NPI:1629145727)

HEALTHCARE PROVIDER: HEENA SHYAMANI M.D.

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

Individual Professional Information
NPI	1629145727
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224160817
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100716000751
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHYAMANI
	Individual professional last name
Provider First Name	HEENA
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	FAMILY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	FAMILY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	484 SUMMIT ST
	Group Practice or individual's line 1 address
City	ELGIN
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	601203829
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140030
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVOCATE SHERMAN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140217
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PRESENCE SAINT JOSEPH HOSPITAL - ELGIN
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y