MEDICARE: GEORGE W SHEHATA 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	036071862	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275530396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE W SHEHATA MD

Provider Business Mailing Address
First Line	:	PO BOX 967
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-0967
Country	:	US
Telephone Number	:	708-532-6029
Fax Number	:	708-532-6095

Provider Business Practice Location Address
First Line	:	3310 S OCEAN BLVD APT 427D
Second Line	:
City	:	HIGHLAND BEACH
State	:	FL
Zip	:	33487-4798
Country	:	US
Telephone Number	:	708-691-9823
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/15/2022

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