Individual
SHEBA AMPALLOOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 E 51ST ST, PROVIDENT HOSPITAL OF COOK COUNTY, CHICAGO, IL 60615-2400
(312) 572-1200
(312) 572-1294
Mailing address
905 E KIMBER LN, ARLINGTON HTS, IL 60005-4320
(847) 427-8834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036099775
IL
207R00000X
Internal Medicine Physician
036-099775
IL
Other
Enumeration date
07/22/2006
Last updated
04/21/2021
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