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NPI Code Detail

MEDICARE: SHANKAR DAS M.D.

MEDICARE: SHANKAR DAS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036119559IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316060965
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANKAR DAS M.D.
Provider Business Mailing Address
First Line : 9680 GOLF RD
Second Line : SECOND FLOOR
City : DES PLAINES
State : IL
Zip : 60016-1522
Country : US
Telephone Number : 847-502-4156
Fax Number :
Provider Business Practice Location Address
First Line : 8700 S DANTE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-7118
Country : US
Telephone Number : 773-221-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 06/20/2014

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