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General NPI Number Information
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NPI Number | 1083978597
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Entity Type | Individual
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Provider Name | SARAH LYNN SHOOK D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 1742 S HILL BLVD
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City | BLOOMFIELD
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State | MI
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Zip | 48304-1136
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Country | US
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Telephone | 313-212-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 W CENTRAL RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-2407
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Country | US
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Telephone | 847-394-3553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 5101019970
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 5315055348
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036140907
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 336102242
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License Number State | IL
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