Individual
MOHAMED IHTESHAM SHAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 564-7400
Mailing address
DEPT OF GME, 4646 N MARINE DR, 7TH FL STE 7100, CHICAGO, IL 60640-5759
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
125.069826
IL
Other
Enumeration date
07/24/2017
Last updated
08/15/2017
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