SHELLEY GALLIVAN (NP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1083807606

SHELLEY GALLIVAN (NP) is a healthcare provider. based in Oak brook, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 17816 (CA). The NPI Number for SHELLEY GALLIVAN (NP) is 1083807606

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
SHELLEY GALLIVAN (NP)
NPI
1083807606
Phone
(630) 954-6700
Address
900 JORIE BLVD
Enumeration Date
27 August 2007
Last Update Date
22 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4089386750
Graduation Year
2022 (4 years ago)
PAC ID
6103179114
Group Practice PAC ID
2769377217
Professional Enrollment ID
I20221031001032
Address ID
CA951261136SA2001XALAM300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:18State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for SHELLEY GALLIVAN (NP)

  • 900, Jorie Boulevard, Oak Brook, DuPage County, Illinois, 60523, United States

    SUITE 186

    OAK BROOK, IL 605232213

    Phone: (630) 954-6700

    Type: Location

  • 1503 GRANT RD STE 110

    MOUNTAIN VIEW, CA 940403270

    Phone: (650) 484-1213

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221031001032INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60523)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769377217View full group profile
NameSpecialtyState
-CA
-CA
P S Y C H I A T R YCA
-CA
Marriage And Family TherapistCA
Clinical Social WorkerCA
P S Y C H I A T R YCA
P S Y C H I A T R YCA
Marriage And Family TherapistCA
P S Y C H I A T R YCA

Reviews

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Frequently asked questions

Can I cross-check SHELLEY GALLIVAN (NP) using NPI 1083807606?
NPI 1083807606 belongs to SHELLEY GALLIVAN (NP); compare other details if you need extra assurance.
Is SHELLEY GALLIVAN (NP) still an active registrant?
SHELLEY GALLIVAN (NP) carries an active NPI according to the public dataset.
What area of care is associated with SHELLEY GALLIVAN (NP)?
SHELLEY GALLIVAN (NP)'s record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SHELLEY GALLIVAN (NP) associated with Oak Brook?
Public fields place SHELLEY GALLIVAN (NP) around Oak Brook, Illinois. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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