MEDICARE: DR. LAVANYA G SHANKAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036115415	IL

General Provider Information

NPI Number	:	1104826544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAVANYA G SHANKAR MD

Provider Business Mailing Address
First Line	:	1890 N BRAYMORE DR
Second Line	:
City	:	BARRINGTON
State	:	IL
Zip	:	60010-6405
Country	:	US
Telephone Number	:	224-622-1770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 BARRINGTON RD
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60194-1019
Country	:	US
Telephone Number	:	847-490-6974
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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