Provider Demographics
NPI:1477247369
Name:ADAMS, SHANAKA K
Entity Type:Individual
Prefix:
First Name:SHANAKA
Middle Name:K
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 N OAK PARK AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1340
Mailing Address - Country:US
Mailing Address - Phone:312-533-1516
Mailing Address - Fax:
Practice Address - Street 1:137 N OAK PARK AVE STE 215
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1340
Practice Address - Country:US
Practice Address - Phone:312-533-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other