Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | IL | |
Y | 103G00000X | Clinical Psychologist | IL | |
Y | 103TC0700X | Clinical Psychologist | IL |
NPI | 1114106697 |
---|---|
Provider Name | Dr. Stewart Aaron Shankman |
First Address | Chicago, IL 60607-7135 |
Second Address | Chicago, IL 60607-7135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2007 |
Last Update Date | 31/10/2007 |