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Individual

DR. BESAGARAHALLY C SHANKARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
406 FRONT ST, SUITE C, MCHENRY, IL 60050-5593
(815) 344-6868
(815) 344-5454
Mailing address
406 NORTH FRONT STREET, SUITE C, MCHENRY, IL 60050
(815) 344-6868
(815) 344-5454

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036070042
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036070042
IL
Enumeration date
01/26/2006
Last updated
05/03/2015
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