Provider Demographics
NPI:1346214483
Name:SHUBER, SUAD (MD)
Entity Type:Individual
Prefix:
First Name:SUAD
Middle Name:
Last Name:SHUBER
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 1:7237 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3546
Mailing Address - Country:US
Mailing Address - Phone:773-589-2600
Mailing Address - Fax:773-625-4460
Practice Address - Street 1:7237 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3546
Practice Address - Country:US
Practice Address - Phone:773-589-2600
Practice Address - Fax:773-625-4460
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36045370207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL527470Medicare ID - Type Unspecified
D12451Medicare UPIN