Provider Demographics
NPI:1700047222
Name:SHIFRIN, KABITA SHEILA (DO)
Entity Type:Individual
Prefix:DR
First Name:KABITA
Middle Name:SHEILA
Last Name:SHIFRIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KABITA
Other - Middle Name:SHEILA
Other - Last Name:DAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:2335 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2104
Mailing Address - Country:US
Mailing Address - Phone:312-590-3572
Mailing Address - Fax:888-716-0671
Practice Address - Street 1:2335 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2104
Practice Address - Country:US
Practice Address - Phone:312-590-3572
Practice Address - Fax:888-716-0671
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036126041207W00000X
IL036.126041207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1083684922OtherESC THE EYE SPECIALISTS CENTER, LLC GROUP NPI
IL1699802421OtherESC OPTICAL NPI
IL036126041Medicaid
ILCK7818OtherESC MEDICARE RAILROAD GROUP PTAN
ILIL6821OtherSHIFRIN GRP MEDICARE PTAN
IL205785OtherESC GRP ILL MEDICARE PTAN COOK COUNTY
ILP00928033OtherESC MEDICARE RAILROAD INDIVIDUAL PTAN
IL205785004OtherESC MEDICARE INDIVIDUAL PTAN
IL01620861OtherESC BLUE CROSS BLUE SHEILD OF ILLINOIS