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Individual

AMANDA SHAIYAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8930 BRONX AVE APT 2B, SKOKIE, IL 60077-1912
(773) 987-1255
Mailing address
8930 BRONX AVE APT 2B, SKOKIE, IL 60077-1912
(773) 987-1255

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S00000089971
IL

Other

Enumeration date
06/05/2025
Last updated
06/05/2025
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