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General NPI Number Information
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NPI Number | 1881629855
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Entity Type | Individual
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Provider Name | KEITH SHULMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4646 N MARINE DR FL 1
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City | CHICAGO
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State | IL
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Zip | 60640-5759
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Country | US
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Telephone | 773-564-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 2368 PAYSPHERE CIR
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City | CHICAGO
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State | IL
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Zip | 60674-2368
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Country | US
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Telephone |
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Fax |
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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 | 036-069610
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License Number State | IL
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