Individual
DR. SHANE JAY NHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 W HARRISON ST, STE 400, CHICAGO, IL 60612-3841
(312) 243-4244
(312) 942-1517
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
(708) 236-2673
(708) 492-5673
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
036-120601
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
# 1633878
BCBS
IL
Enumeration date
05/13/2008
Last updated
12/12/2022
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