Individual
ISA SHAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4050 HEALTHWAY DR STE 110, AURORA, IL 60504-8184
(630) 888-1443
Mailing address
27105 TIMBER WOOD CT, PLAINFIELD, IL 60585-2952
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
S52041805121
IL
Other
Enumeration date
10/07/2025
Last updated
01/02/2026
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