Shantharaj Samuel M.d.,s.c.

NPI #1831375559 in Chicago, Illinois

Provider Information

NPI Number: 1831375559
Entity Type: Organization
Organization Name: Shantharaj Samuel M.d.,s.c.
Primary Specialty: Specialist
Enumeration Date: Jan 11, 2008
Last Updated: Jan 11, 2008

Practice Location

Address: 3942 N CENTRAL AVE
City: Chicago
State: Illinois
ZIP Code: 60634-2732
Phone: (773) 736-6220

Authorized Official

Name: DR. SHANTHARAJ SAMUEL, M.D.
Title: PEDIATRICIAN
Phone: (773) 736-6220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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