Individual
DR. DYLAN MICHAEL SHIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
(714) 397-2512
Mailing address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
125-080352
IL
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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