Individual
DR. BEVERLY E SHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 S PAULINA ST, SUITE 143, CHICAGO, IL 60612-3806
(312) 942-5865
(312) 942-2184
Mailing address
600 S PAULINA ST STE 140AAC, CHICAGO, IL 60612-3806
(312) 942-5865
(312) 942-2184
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-075746
IL
207RI0200X
Infectious Disease Physician
Primary
036075746
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075746
—
IL
01
—
440003645
RR MEDICARE
IL
Enumeration date
03/28/2006
Last updated
04/30/2021
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