Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 37731 | IA |
N | 208600000X | Surgeon | 37731 | IA |
N | 208200000X | Surgeon | 44528 | WI |
N | 208600000X | Surgeon | 44528 | WI |
Y | 2086S0120X | Pediatric Surgery | 35.120176 | OH |
N | 2086S0120X | Pediatric Surgery | 37731 | IA |
NPI | 1184688756 |
---|---|
Provider Name | Aimen F Shaaban |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 31/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0076625 | (05) | OH |
200969860 | (05) | IN |
3810025105 | (05) | WV |
72299 | WELLMARK BCBS (01) | IA |
H71052 | (02) |