Provider Demographics
NPI:1043576341
Name:FALITZ, SHAWN MARTEN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MARTEN
Last Name:FALITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:J4-331
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-296-5362
Mailing Address - Fax:216-445-2536
Practice Address - Street 1:4201 W MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8409
Practice Address - Country:US
Practice Address - Phone:815-344-5000
Practice Address - Fax:815-344-3347
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH131338207L00000X
IL036167291207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology