Organization
SHANTHARAJ SAMUEL M.D.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANTHARAJ SAMUEL M.D. (PEDIATRICIAN)
(773) 736-6220
Entity
Organization
Contact information
Practice address
3942 N CENTRAL AVE, CHICAGO, IL 60634-2732
(773) 736-6220
Mailing address
3942 N CENTRAL AVE, CHICAGO, IL 60634-2732
(773) 736-6220
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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