DR. SHELLY MANN MD NPI 1194719211

NPI Information

  • NPI: 1194719211
  • Provider Name: DR. SHELLY MANN, MD
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1170 E BELVEDERE RD #106
    GRAYSLAKE, IL
    ZIP 60030
  • Phone: (847) 548-7337

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NPI Details

DR. Shelly Mann, MD is an adolescent medicine pediatrics in Grayslake, IL. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Shelly Mann, MD NPI is 1194719211. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1170 E BELVEDERE RD #106
GRAYSLAKE, IL
ZIP 60030
Phone: (847) 548-7337
Fax: (847) 548-9909

The NPI 1194719211 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/2/2005 and was last updated on 12/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine036106369ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036106369MEDICAIDILLINOIS
2006726984MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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