Individual
SHAKUNTALA HANUMANT MAUZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS,MD
Contact information
Practice address
701 N. FIRST ST, SPRINGFIELD, IL 62781-0002
(217) 788-3000
(217) 788-5577
Mailing address
PO BOX 5995, CAROL STREAM, IL 60197-5995
(713) 500-5302
(713) 500-0712
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
036.145741
IL
Other
Enumeration date
07/17/2012
Last updated
06/13/2018
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