Individual
DR. JIHAD IZZAT SHOSHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
636 RAYMOND DR, SUITE 205, NAPERVILLE, IL 60563-9789
(630) 717-2300
(630) 717-9638
Mailing address
636 RAYMOND DR, SUITE 205, NAPERVILLE, IL 60563-9789
(630) 717-2300
(630) 717-9638
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036098654
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098654
—
IL
01
—
2215474
BCBS OF ILLINOIS
IL
Enumeration date
11/30/2005
Last updated
10/04/2011
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