Mahadevan, Shobha

Mahadevan, Shobha is an individual health care provider with primary practice located at Health Services Northern Illinois University, Wirtz Drive, Dekalb IL 60115. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Mahadevan, Shobha can be contacted via phone (815) 753-1311.

Contact Information

Primary practice address
Health Services Northern Illinois University, Wirtz Drive Dekalb IL 60115
Phone: (815) 753-1311
Fax: (815) 753-5906
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X Illinois

Profile Details

NPI number 1821082231
LBN Legal business name Mahadevan, Shobha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1821082231 NPPES
Illinois MEDICAID 036-096889-1

Popular Providers