Individual
SHELLY LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, LUH - NORTH ENT., RM. 7604, MAYWOOD, IL 60153-3328
(708) 216-3304
(708) 216-1259
Mailing address
2160 S 1ST AVE, LUH - NORTH ENT., RM. 7604, MAYWOOD, IL 60153-3328
(708) 216-3304
(708) 216-1259
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
36111532
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36111532
—
IL
Enumeration date
12/29/2005
Last updated
02/01/2022
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