Provider Demographics
NPI:1902335433
Name:SHUKHMAN, REBECCA PAMELA (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:PAMELA
Last Name:SHUKHMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SCHELTER RD STE 103A
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-3632
Mailing Address - Country:US
Mailing Address - Phone:847-790-4063
Mailing Address - Fax:
Practice Address - Street 1:101 SCHELTER RD STE 103A
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3632
Practice Address - Country:US
Practice Address - Phone:847-853-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361565932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry