Provider Demographics
NPI:1043472970
Name:FRANCIS, SHANI (MD)
Entity Type:Individual
Prefix:
First Name:SHANI
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 SHERMAN AVE STE 323
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4421
Mailing Address - Country:US
Mailing Address - Phone:877-368-4270
Mailing Address - Fax:
Practice Address - Street 1:296 COTTAGE AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-4942
Practice Address - Country:US
Practice Address - Phone:209-624-7006
Practice Address - Fax:209-554-4601
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC150098207N00000X
IL036.127511207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology