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Individual

MS. SUSANNE SHOKOOHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2160 S 1ST AVE, BUILDING 54 ROOM 167, MAYWOOD, IL 60153
(708) 216-9230
Mailing address
1 FORD PL STE 2E, DETROIT, MI 48202-3450
(313) 874-4806

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036137918
IL
207RG0100X
Gastroenterology Physician
Primary
4301504245
MI

Other

Enumeration date
03/29/2011
Last updated
04/02/2021
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