Provider Demographics
NPI:1568595882
Name:SHAMSI, TALHA
Entity Type:Individual
Prefix:
First Name:TALHA
Middle Name:
Last Name:SHAMSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6918 ELEANOR PL
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-3949
Mailing Address - Country:US
Mailing Address - Phone:773-370-9725
Mailing Address - Fax:
Practice Address - Street 1:6918 ELEANOR PL
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-3949
Practice Address - Country:US
Practice Address - Phone:773-370-9725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210196Medicare ID - Type Unspecified