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NPI Code Detail

MEDICARE: LEO BRIAN SHIMANOVICH MD

MEDICARE: LEO BRIAN SHIMANOVICH 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
12084N0400XNeurology Physician2084N0400XIL

General Provider Information

NPI Number : 1134796964
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO BRIAN SHIMANOVICH MD
Provider Business Mailing Address
First Line : 600 S PAULINA ST STE 403
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3806
Country : US
Telephone Number : 312-942-0312
Fax Number :
Provider Business Practice Location Address
First Line : 600 S PAULINA ST STE 403
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3806
Country : US
Telephone Number : 312-942-0312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2021
Last Update Date : 05/19/2026

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Directions to “ LEO BRIAN SHIMANOVICH MD” Practice Location

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