Individual
THOMAS P SHANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611
(312) 227-4340
(312) 227-9637
Mailing address
225 E CHICAGO AVE # 86, CHICAGO, IL 60611-2991
(312) 227-4340
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301061940
MI
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
4301061940
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4638831
—
MI
Enumeration date
07/31/2006
Last updated
07/27/2018
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