Healthcare Provider Details

I. General information

NPI: 1164415485
Provider Name (Legal Business Name): JAMES C SHEININ, M.D., LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE 1216
CHICAGO IL
60602-1903
US

IV. Provider business mailing address

111 N WABASH AVE 1216
CHICAGO IL
60602-1903
US

V. Phone/Fax

Practice location:
  • Phone: 312-346-1891
  • Fax:
Mailing address:
  • Phone: 312-346-1891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-039955
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036-039955
License Number StateIL

VIII. Authorized Official

Name: DR. JAMES C SHEININ
Title or Position: PRESIDENT PHYSICIAN
Credential: M.D.
Phone: 312-346-1891