Healthcare Provider Details

I. General information

NPI: 1033649439
Provider Name (Legal Business Name): HARRIS SHAIKH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date: 06/30/2022
Reactivation Date: 07/28/2022

III. Provider practice location address

4400 W 95TH ST
OAK LAWN IL
60453-2654
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-3074
  • Fax: 708-684-2675
Mailing address:
  • Phone: 847-390-5900
  • Fax: 847-390-4757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036.165575
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number5101023589
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: