Provider Demographics
NPI:1326165358
Name:SHAHIN, ALDONA T (THERAPY DIR I)
Entity Type:Individual
Prefix:
First Name:ALDONA
Middle Name:T
Last Name:SHAHIN
Suffix:
Gender:F
Credentials:THERAPY DIR I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8125 RIVER DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2642
Mailing Address - Country:US
Mailing Address - Phone:847-470-1720
Mailing Address - Fax:847-470-1723
Practice Address - Street 1:8125 RIVER DR STE 102
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2642
Practice Address - Country:US
Practice Address - Phone:847-470-1720
Practice Address - Fax:847-470-1723
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070006977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist