Healthcare Provider Details

I. General information

NPI: 1013302405
Provider Name (Legal Business Name): MICHAEL SHAWN ORANGIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 05/31/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

571 S FLOYD ST STE 414
LOUISVILLE KY
40202-3877
US

V. Phone/Fax

Practice location:
  • Phone: 312-503-3936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number52703
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number036160487
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: