Provider Demographics
NPI:1558773663
Name:SHAHEN, SAMIR NASER (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:NASER
Last Name:SHAHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9048 CRESCENT CT
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-1451
Mailing Address - Country:US
Mailing Address - Phone:708-257-6001
Mailing Address - Fax:773-278-9628
Practice Address - Street 1:1044 N FRANCISCO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2743
Practice Address - Country:US
Practice Address - Phone:773-292-8200
Practice Address - Fax:773-278-9628
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036141409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine