Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 227982 | NY |
N | 207V00000X | Obstetrician & Gynecologist | 48222 | CT |
Y | 207VX0201X | Gynecologic Oncologist | 036137207 | IL |
N | 207VX0201X | Gynecologic Oncologist | 48222 | CT |
NPI | 1205916764 |
---|---|
Provider Name | Shohreh Shahabi |
First Address | Chicago, IL 60611-2914 |
Second Address | Chicago, IL 60611-2914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 16/10/2017 |