Individual
SHAVONNE SAHARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 W ENGLEWOOD AVE, CHICAGO, IL 60621-2053
(773) 683-9135
Mailing address
600 W ENGLEWOOD AVE, CHICAGO, IL 60621-2053
(773) 683-9135
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
258000123
IL
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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