Individual
DR. DANIEL SHIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2284 COUNTY LINE RD, ALGONQUIN, IL 60102-2561
(847) 723-6465
Mailing address
835 JUDSON AVE APT 310, EVANSTON, IL 60202-2431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-126993
IL
390200000X
Student in an Organized Health Care Education/Training Program
125055276
IL
Other
Enumeration date
08/03/2008
Last updated
06/22/2011
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