Individual
DR. SHISHIN YAMADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1890 SILVER CROSS BLVD, PAVILION A, SUITE 560, NEW LENOX, IL 60451-9583
(815) 714-9362
(815) 846-1777
Mailing address
1890 SILVER CROSS BLVD, STE 550, NEW LENOX, IL 60451-9579
(815) 714-9362
(815) 846-1777
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036112458
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112458
—
IL
Enumeration date
08/08/2006
Last updated
05/13/2020
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