Individual
GAURI JAYA SHANKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(217) 714-3701
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.081601
IL
207RH0003X
Hematology & Oncology Physician
125.081601
IL
Other
Enumeration date
03/28/2023
Last updated
04/28/2026
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