MEDICARE: DAVID SHAPIRO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1518350131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID SHAPIRO

Provider Business Mailing Address
First Line	:	303 E CHICAGO AVE STE 1-003
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4296
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 E ERIE ST
Second Line	:	APT 3303
City	:	CHICAGO
State	:	IL
Zip	:	60611-4446
Country	:	US
Telephone Number	:	610-293-9491
Fax Number	:

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

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	05/08/2018

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Directions to “ DAVID SHAPIRO ” Practice Location

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