Provider Demographics
NPI:1144275546
Name:SHLIAPOCHNIK, SILVANA
Entity type:Individual
Prefix:
First Name:SILVANA
Middle Name:
Last Name:SHLIAPOCHNIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2837 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7403
Mailing Address - Country:US
Mailing Address - Phone:773-235-6266
Mailing Address - Fax:773-235-9054
Practice Address - Street 1:2837 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7403
Practice Address - Country:US
Practice Address - Phone:773-235-6266
Practice Address - Fax:773-235-9054
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036066135207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036066135Medicaid
902770Medicare ID - Type Unspecified
C48423Medicare UPIN