Mohamed Ihtesham Shaji, MD | |
4646 N Marine Dr, Chicago, IL 60640-5759 | |
(773) 564-7400 | |
Not Available |
Full Name | Mohamed Ihtesham Shaji |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 13 Years |
Location | 4646 N Marine Dr, Chicago, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194248914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RA0000X | Internal Medicine - Adolescent Medicine | 125.069826 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ascension Se Wisconsin Hospital - St Joseph Campus | Milwaukee, WI | Hospital |
Ascension Columbia St Mary's Hospital Milwaukee | Milwaukee, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wheaton Franciscan Medical Group Inc | 8628980943 | 565 |
Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
Mailing Address | Practice Location Address |
---|---|
Mohamed Ihtesham Shaji, MD Dept Of Gme, 4646 N Marine Dr, 7th Fl Ste 7100, Chicago, IL 60640-5759 Ph: () - | Mohamed Ihtesham Shaji, MD 4646 N Marine Dr, Chicago, IL 60640-5759 Ph: (773) 564-7400 |
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