| Doctor Name: | MR. SHANE ERIK BISHIR |
| NPI Number: | 1528296944 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A.,CCC-SLP/L |
| License Number: | 146-006058 |
| Business Practice Address: | 1245 Corporate Blvd Suite 101 Aurora, IL - 605057607 |
| Business Phone Number: | 6308982200 |
| Business Fax Number: | |
| Mailing Address: | 2054 Middlebury Dr, AURORA |
| State: | IL |
| Postal Code: | 605035442 |
| Phone Number: | 6308987080 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2009 |
| NPI Last Update Date: | 06/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 146-006058 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |