Provider Demographics
NPI:1275570699
Name:HILLMAN, SHONA M (MD)
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:M
Last Name:HILLMAN
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 1:33000 PORTOFINO CIR APT 110
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-1279
Mailing Address - Country:US
Mailing Address - Phone:773-367-4150
Mailing Address - Fax:681-245-8167
Practice Address - Street 1:33000 PORTOFINO CIR APT 110
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-1279
Practice Address - Country:US
Practice Address - Phone:773-367-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME140577207Q00000X
CAC146051207Q00000X
IL036102783207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH72502Medicare UPIN