Shoshara, Jihad Izzat

Shoshara, Jihad Izzat is an individual health care provider with primary practice located at 636 Raymond Dr Suite 205, Naperville IL 60563-9789. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Shoshara, Jihad Izzat can be contacted via phone (630) 717-2300.

Contact Information

Primary practice address
636 Raymond Dr Suite 205 Naperville IL 60563-9789
Phone: (630) 717-2300
Fax: (630) 717-9638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036098654 Illinois

Profile Details

NPI number 1770567018
LBN Legal business name Shoshara, Jihad Izzat
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Oct 4th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770567018 NPPES
Illinois Other 2215474 BCBS OF ILLINOIS
Illinois MEDICAID 036098654 BCBS OF ILLINOIS

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