Provider Demographics
NPI:1689938938
Name:SHUJA, ASIM (MD)
Entity Type:Individual
Prefix:
First Name:ASIM
Middle Name:
Last Name:SHUJA
Suffix:
Gender:M
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:ASIM SHUJA
Mailing Address - Street 2:840 S WOOD STREET, SUITE 718E CSB, MC 716
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-6652
Mailing Address - Fax:
Practice Address - Street 1:ASIM SHUJA
Practice Address - Street 2:840 S WOOD STREET, SUITE 718E CSB, MC 716
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253082207R00000X
FLTRN21544207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine