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General NPI Number Information
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NPI Number | 1518932227
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Entity Type | Individual
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Provider Name | MISHAIL A SHAPIRO D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 06/01/2024
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Provider Practice Location Address
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Address Line | 114 W ROCKLAND RD
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-2774
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Country | US
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Telephone | 847-353-8802
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Fax | 847-353-8812
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Provider Business Mailing Address
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Address Line | 114 W ROCKLAND RD STE 101
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-2797
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Country | US
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Telephone | 847-353-8802
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Fax | 866-700-1910
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036100018
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License Number State | IL
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