Basic Information
| Provider Information | |||||||||
| NPI: | 1093780926 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAKLA NAMAS | ||||||||
| FirstName: | SHAKIB | ||||||||
| MiddleName: | SHOKRY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6400 SHAFER CT STE 700 | ||||||||
| Address2: | |||||||||
| City: | ROSEMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600184989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3463761702 | ||||||||
| FaxNumber: | 2245322780 | ||||||||
| Practice Location | |||||||||
| Address1: | 17757 US HIGHWAY 19 N STE 175 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337646564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7272709800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2006 | ||||||||
| LastUpdateDate: | 11/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QH0002X | ME47201 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | 2081P0004X | 036087200 | IL | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Spinal Cord Injury Medicine | 207RG0300X | 036087200 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.