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General NPI Number Information
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NPI Number | 1306000542
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Entity Type | Individual
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Provider Name | STEPHANIE SHORS MD
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST STE 456
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City | CHICAGO
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State | IL
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Zip | 60612-3866
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Country | US
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Telephone | 312-563-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N LAKE SHORE DR APT 1812
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City | CHICAGO
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State | IL
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Zip | 60611-1523
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Country | US
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Telephone | 312-867-7178
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036115599
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 036.115599
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License Number State | IL
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