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Individual

SHIVANJALI SHANKARAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 S PAULINA ST STE 140, CHICAGO, IL 60612-3806
(312) 942-5865
Mailing address
600 S PAULINA ST STE 140, CHICAGO, IL 60612-3806
(312) 942-5865

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-143813
IL
207RI0200X
Infectious Disease Physician
0101249722
VA
207RI0200X
Infectious Disease Physician
Primary
036-143813
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-032
TRICARE/CHAMPUS
VA
01
10091628
OPTIMA HEALTH
VA
01
1861628364
UNITED HEALTHCARE
VA
05
1861628364
VA
01
456782
ANTHEM BC/BS
VA
05
5920094
NC
01
PAR
MULTIPLAN
VA
Enumeration date
06/10/2009
Last updated
07/18/2023
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