Provider Demographics
NPI:1255650354
Name:SHLIMON, ALAN ESHA
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:ESHA
Last Name:SHLIMON
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 1:1815 BALMORAL CT
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1307
Mailing Address - Country:US
Mailing Address - Phone:312-388-2526
Mailing Address - Fax:773-696-9110
Practice Address - Street 1:5400 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1272
Practice Address - Country:US
Practice Address - Phone:312-388-2526
Practice Address - Fax:773-696-9110
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist