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General NPI Number Information
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NPI Number | 1679567416
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Entity Type | Individual
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Provider Name | SHEPHALI C KATIRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2300 N CHILDRENS PLZ OUTREACH PHYSICIAN SERVICES
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City | CHICAGO
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State | IL
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Zip | 60614-3363
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Country | US
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Telephone | 773-880-6903
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Fax | 773-880-3068
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Provider Business Mailing Address
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Address Line | 2300 N CHILDRENS PLZ BOX 152
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City | CHICAGO
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State | IL
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Zip | 60614-3363
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Country | US
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Telephone | 773-880-6903
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Fax | 773-880-3068
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01094668A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01094668A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036-100782
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License Number State | IL
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