Individual
ENAS MOHAMED SHANSHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 N 9TH ST FL 2, SPRINGFIELD, IL 62702-5310
(217) 545-8000
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
45984
TX
2080P0202X
Pediatric Cardiology Physician
Primary
46386
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200724170A
—
OK
05
—
379876101
—
TX
05
—
379876102
—
TX
05
—
82004234
—
NM
Enumeration date
11/15/2011
Last updated
07/20/2021
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