Individual
DR. SITTANUR SHOUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
25 N. WINFIELD RD STE 401, WINFIELD, IL 60190
(630) 933-4200
(630) 933-4210
Mailing address
25 N. WINFIELD RD STE 401, WINFIELD, IL 60190
(630) 933-4200
(630) 933-4210
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036125417
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036125417
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400172817
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
08/14/2008
Last updated
12/16/2014
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