MEDICARE: DAVID M SHEVITZ 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	2086S0129X	Vascular Surgery Physician	ME74461	FL
2	207K00000X	Allergy & Immunology Physician	42176	TN
3	207P00000X	Emergency Medicine Physician	2007-00905	NC
4	202K00000X	Phlebology Physician	ME74461	NC

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	:	1548257058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M SHEVITZ MD

Provider Business Mailing Address
First Line	:	1901 BUTTERFIELD RD
Second Line	:	SUITE 220
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-7915
Country	:	US
Telephone Number	:	630-725-2768
Fax Number	:	630-725-2783

Provider Business Practice Location Address
First Line	:	5550 GLADES RD
Second Line	:	SUITE 210
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7205
Country	:	US
Telephone Number	:	561-750-2130
Fax Number	:	561-367-6170

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	03/16/2012

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Directions to “ DAVID M SHEVITZ MD” Practice Location

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