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NPI Code Detail

MEDICARE: YVONE SHAMETAJ MD

MEDICARE: YVONE SHAMETAJ MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084N0400XNeurology Physician125.087984IL

General Provider Information

NPI Number : 1386442523
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVONE SHAMETAJ MD
Provider Business Mailing Address
First Line : 600 S PAULINA ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3806
Country : US
Telephone Number : 608-358-9398
Fax Number :
Provider Business Practice Location Address
First Line : 600 S PAULINA ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3806
Country : US
Telephone Number : 608-358-9398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2025
Last Update Date : 06/15/2026

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