Individual
DR. SHANE MAXWELL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 W HARRISON ST STE 970, CHICAGO, IL 60612-3828
(215) 350-8914
Mailing address
1725 W HARRISON ST STE 970, CHICAGO, IL 60612-3828
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
125084655
IL
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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