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NPI Code Detail

MEDICARE: NAZIK SHABAN

MEDICARE: NAZIK SHABAN
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
1122300000XDentist019.028648IL

General Provider Information

NPI Number : 1467730275
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAZIK SHABAN
Provider Business Mailing Address
First Line : 430 W ERIE ST
Second Line : SUITE 200
City : CHICAGO
State : IL
Zip : 60654-6914
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2821 GRAND AVE
Second Line :
City : WAUKEGAN
State : IL
Zip : 60085-2372
Country : US
Telephone Number : 847-662-4400
Fax Number : 847-662-4401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2011
Last Update Date : 01/11/2013

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Directions to “ NAZIK SHABAN ” Practice Location

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