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NPI Code Detail

MEDICARE: SHAINA MANN PA-C

MEDICARE: SHAINA MANN PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1164374492
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAINA MANN PA-C
Provider Business Mailing Address
First Line : 641 W FULLERTON PKWY UNIT G
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2677
Country : US
Telephone Number : 317-979-6339
Fax Number :
Provider Business Practice Location Address
First Line : 641 W FULLERTON PKWY UNIT G
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2677
Country : US
Telephone Number : 317-979-6339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “ SHAINA MANN PA-C” Practice Location

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