JUSTIN LEE SHANK (PA-C) – Physician Assistant, NPI 1598280463
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for JUSTIN LEE SHANK (PA-C)
1519 W NELSON ST # FB2
CHICAGO, IL 606579358
Phone: (210) 289-3099
Type: Mailing
17800 Kedzie Ave
Hazel Crest, IL 604292029
Phone: (708) 799-8000
Type: Location
17800, Kedzie Avenue, Hazel Crest, Bremen Township, Cook County, Illinois, 60429, United States
HAZEL CREST, IL 604292029
Phone: (708) 799-8000
Type: Location
29373 NETWORK PL
CHICAGO, IL 606731293
Phone: (847) 390-5900
Fax: (847) 390-4757
Type: Mailing
9550 W 167TH ST
ORLAND PARK, IL 604675561
Phone: (708) 873-4500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $150.
Total Amount is formed as General ($150) + Research ($0) + Ownership ($0) = $150.
Last reported payment date: 2023-07-26 • Largest payer in this snapshot: Davol Inc. ($150).
Total Amount
$150
General + Research + Ownership
Payments
1
Total payment records
General Amount
$150
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Davol Inc. | $150 |
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: 2017-11-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171110001605 | I | Physician Assistant | IL | TBD |
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.
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 60657)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nephrology, Internal Medicine | IL | |
| A N E S T H E S I O L O G Y | IL | |
| - | MN | |
| - | IL | |
| - | IL | |
| Rheumatology, Internal Medicine | IL | |
| - | IL | |
| Internal Medicine | IL | |
| P S Y C H I A T R Y | IL | |
| - | IL |
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