Individual
DR. DAVID MICHAEL SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 W WELLINGTON AVE, STE. 200, CHICAGO, IL 60657-4325
(773) 280-1011
(773) 281-1029
Mailing address
1011 W WELLINGTON AVE, STE. 200, CHICAGO, IL 60657-4325
(773) 280-1011
(773) 281-1029
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-129535
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036129535
—
IL
Enumeration date
07/11/2007
Last updated
07/12/2019
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