Doctor Name: | SHELLY LO |
NPI Number: | 1013994086 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 36111532 |
Business Practice Address: | 2160 S 1st Ave Luh - North Ent., Rm. 7604 Maywood, IL - 601533328 |
Business Phone Number: | 7082163304 |
Business Fax Number: | 7082161259 |
Mailing Address: | 2160 S 1st Ave, Luh - North Ent., Rm. 7604 MAYWOOD |
State: | IL |
Postal Code: | 601533328 |
Phone Number: | 7082163304 |
Fax Number: | 7082161259 |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 10/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RH0003X |
License Number: | 36111532 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Hematology & Oncology |
Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |