MYSORE N SHIVARAM MD SC NPI 1679888341

NPI Information

MYSORE N SHIVARAM MD SC is an addiction medicine internal medicine in Berwyn, IL. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. MYSORE N SHIVARAM MD SC NPI is 1679888341. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6901 CERMAK RD
BERWYN, IL
ZIP 60402-160
Phone: (708) 484-5660
Fax: (708) 484-0194

The provider's authorized official is Mysore N Shivaram .
The authorized official title is Physician and has the following contact phone number (708) 484-5660.

The enumeration date for this NPI number is 8/18/2010 and was last updated on 10/15/2014.

Taxonomy Codes

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