Provider Demographics
NPI:1629547807
Name:SHORI, AKHIL CHANDER (MD)
Entity type:Individual
Prefix:
First Name:AKHIL
Middle Name:CHANDER
Last Name:SHORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-4607
Mailing Address - Country:US
Mailing Address - Phone:815-802-7090
Mailing Address - Fax:815-802-7091
Practice Address - Street 1:100 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4607
Practice Address - Country:US
Practice Address - Phone:815-802-7090
Practice Address - Fax:815-802-7091
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-17
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN738852081P2900X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine