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General NPI Number Information
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NPI Number | 1750540233
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Entity Type | Individual
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Provider Name | SHISHIR K MAITHEL MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 675 N SAINT CLAIR ST STE 21-100
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City | CHICAGO
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State | IL
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Zip | 60611-5970
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Country | US
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Telephone | 312-695-0990
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Fax | 312-695-1144
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Provider Business Mailing Address
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Address Line | 675 N SAINT CLAIR ST STE 21-100
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City | CHICAGO
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State | IL
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Zip | 60611-5970
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Country | US
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Telephone | 312-695-0990
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Fax | 312-695-1144
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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 | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 062739
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 036171477
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License Number State | IL
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