Provider Demographics
NPI:1457642936
Name:CORDIS, SHAMIKA (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAMIKA
Middle Name:
Last Name:CORDIS
Suffix:
Gender:F
Credentials:DC
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 5977
Mailing Address - Street 2:DEPT 20-3028
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5977
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-701-1007
Practice Address - Street 1:3927 W BELMONT AVE
Practice Address - Street 2:STE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-5170
Practice Address - Country:US
Practice Address - Phone:773-557-7780
Practice Address - Fax:773-557-7781
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor