RICKY D SHAPIRO PA C
Allergy and Immunology
Des Plaines, Illinois
Provider NPI: 1457330425
Provider Information:RICKY D SHAPIRO PA C
Practice Location:
9301 GOLF RD STE 301 DES PLAINES, IL 60016 US
Tel: 847-635-7300 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | IL | 085002100 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| MEDICARE PTAN | IL7072002 | IL | 01 |
| 085002100 | IL | 05 | |
| MEDICARE PTAN | IL7073002 | IL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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