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General NPI Number Information
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NPI Number | 1780806091
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Entity Type | Organization
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Legal Business Name | DAVID B. SHANKER, M.D.
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1425 N HUNT CLUB RD STE 204
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City | GURNEE
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State | IL
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Zip | 60031-2635
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Country | US
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Telephone | 847-855-0125
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 N HUNT CLUB RD STE 204
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City | GURNEE
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State | IL
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Zip | 60031-2635
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Country | US
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Telephone | 847-855-0125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID BRYAN SHANKER
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Credential |
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Telephone | 847-855-0125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | IL
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