Individual
SIVAD EUGENE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RKT
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-2654
Mailing address
2230 S 15TH AVE, BROADVIEW, IL 60155-4006
(773) 569-7763
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1960
NC
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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