Individual
DR. SHADWAN F ALSAFWAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17850 KEDZIE AVE STE 3250, HAZEL CREST, IL 60429-2082
(708) 799-8700
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(901) 302-2360
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
39235
TN
207RC0000X
Cardiovascular Disease Physician
41527
AZ
207RI0011X
Interventional Cardiology Physician
Primary
036-098886
IL
207RI0011X
Interventional Cardiology Physician
39235
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I062027
MEDICARE
TN
05
—
3337932
—
TN
05
—
425003
—
AZ
Enumeration date
09/14/2006
Last updated
08/31/2022
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