Individual
HAIDER A SHIRAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17333 LA GRANGE RD, SUITE 100, TINLEY PARK, IL 60487-7502
(708) 448-9393
(708) 448-7530
Mailing address
17333 LA GRANGE RD, SUITE 100, TINLEY PARK, IL 60487-7502
(708) 448-9393
(708) 448-7530
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036123178
IL
2085R0001X
Radiation Oncology Physician
125051665
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123178
—
IL
01
—
125051665
TEMPORARY LICENSE IN ILLINOIS
IL
Enumeration date
07/30/2008
Last updated
08/07/2013
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