Individual
DR. MARK SHUKHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
36-103040
IL
2084P0800X
Psychiatry Physician
Primary
036-103040
IL
2084P0805X
Geriatric Psychiatry Physician
036-103040
IL
208D00000X
General Practice Physician
036-103040
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-103040
—
IL
Enumeration date
05/10/2006
Last updated
02/10/2017
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