Provider Demographics
NPI:1730297607
Name:UNAL, SHEREF HAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEREF
Middle Name:HAN
Last Name:UNAL
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:PO BOX 19658
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9658
Mailing Address - Country:US
Mailing Address - Phone:217-545-8002
Mailing Address - Fax:217-545-0130
Practice Address - Street 1:301 N 8TH ST
Practice Address - Street 2:SUITE PAV 4A
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62701-1041
Practice Address - Country:US
Practice Address - Phone:217-545-8000
Practice Address - Fax:217-545-0130
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-118418208000000X
SC25215208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118418Medicaid
SC252158Medicaid
SCAA1187Medicare PIN
I47325Medicare UPIN
IL036118418Medicaid