Provider Demographics
NPI:1972609253
Name:SHAPIRO, YURY L (MD)
Entity type:Individual
Prefix:MR
First Name:YURY
Middle Name:L
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 W OAKTON ST
Mailing Address - Street 2:OAKTON HEALTH CENTER
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2953
Mailing Address - Country:US
Mailing Address - Phone:847-329-0470
Mailing Address - Fax:847-329-0472
Practice Address - Street 1:4860 W OAKTON
Practice Address - Street 2:OAKTON HEALTH CENTER
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2953
Practice Address - Country:US
Practice Address - Phone:847-329-0470
Practice Address - Fax:847-329-0472
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36069460Medicaid
IL01607879OtherBCBS
IL01607879OtherBCBS
IL01607879OtherBCBS
IL36069460Medicaid