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NPI Code Detail

MEDICARE: SHAFIC KAKOOZA MD

MEDICARE: SHAFIC KAKOOZA 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
1207R00000XInternal Medicine Physician125.088030IL

General Provider Information

NPI Number : 1790618700
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAFIC KAKOOZA MD
Provider Business Mailing Address
First Line : 5145 N CALIFORNIA AVE
Second Line : DEPT OF GME
City : CHICAGO
State : IL
Zip : 60625-3661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5145 N CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3661
Country : US
Telephone Number : 773-878-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ SHAFIC KAKOOZA MD” Practice Location

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