Provider Demographics
NPI:1831488741
Name:BUFALINO, SHAMS BAKHOS (MD)
Entity Type:Individual
Prefix:
First Name:SHAMS
Middle Name:BAKHOS
Last Name:BUFALINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAMS
Other - Middle Name:
Other - Last Name:BAKHOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1700 LUTHER LN
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1270
Mailing Address - Country:US
Mailing Address - Phone:847-268-8200
Mailing Address - Fax:
Practice Address - Street 1:1700 LUTHER LN
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1270
Practice Address - Country:US
Practice Address - Phone:847-268-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-134665207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology