Provider Demographics
NPI:1144208638
Name:CHIN-BONDS, SHAUNDA P (DO)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNDA
Middle Name:P
Last Name:CHIN-BONDS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:3700 W 203RD ST
Practice Address - Street 2:STE110
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461
Practice Address - Country:US
Practice Address - Phone:708-679-1890
Practice Address - Fax:708-747-9859
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109953207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109953Medicaid
IL594850Medicare ID - Type Unspecified
IL036109953Medicaid