Healthcare Provider Details

I. General information

NPI: 1851311450
Provider Name (Legal Business Name): HARISH N SHOWNKEEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD ROAD SUITE 500
WINFIELD IL
60190-1295
US

IV. Provider business mailing address

25 N WINFIELD ROAD SUITE 500
WINFIELD IL
60190-1295
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-2113
  • Fax: 630-933-4520
Mailing address:
  • Phone: 630-933-2113
  • Fax: 630-933-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number036090410
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: