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General NPI Number Information
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NPI Number | 1669583431
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Entity Type | Individual
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Provider Name | ABDUR R. SHAKIR MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 1000 HEALTH CENTER DR
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City | MATTOON
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State | IL
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Zip | 61938-9261
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Country | US
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Telephone | 217-258-2250
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Fax | 217-258-2249
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Provider Business Mailing Address
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Address Line | 1005 HEALTH CENTER DR STE 201
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City | MATTOON
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State | IL
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Zip | 61938-4693
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Country | US
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Telephone | 217-238-6055
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Fax | 217-258-2216
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 036-118125
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 036-118125
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD-13902
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-118125
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License Number State | IL
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