Organization
RICHARD D. SHIN, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD D SHIN M.D. (PHYSICIAN / OWNER)
(630) 718-0200
Entity
Organization
Contact information
Practice address
1225 W LAKE ST, MELROSE PARK, IL 60160-4039
(708) 938-7580
(708) 938-7381
Mailing address
1730 PARK ST, SUITE 101, NAPERVILLE, IL 60563-2688
(630) 718-0200
(630) 718-0900
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622834
BLUE CROSS / BLUE SHIELD
IL
Enumeration date
08/10/2006
Last updated
11/12/2007
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