Individual
MOHAMMAD R SHAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1150 ESSINGTON RD STE 101, JOLIET, IL 60435-8447
(888) 938-3838
(888) 919-1083
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(888) 720-2012
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036-105323
IL
207Y00000X
Otolaryngology Physician
48503020
WI
207YX0901X
Otology & Neurotology Physician
48503
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022505
WELLMARK
—
05
—
036105323
—
IL
05
—
34689900
—
WI
05
—
6520350
—
SD
01
—
9213433
DAKOTA CARE
—
Enumeration date
01/23/2007
Last updated
03/18/2024
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