Basic Information
| Provider Information | |||||||||
| NPI: | 1801119730 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAIKH | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | COHON | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | COHON | ||||||||
| OtherFirstName: | LAURA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2500 W HIGGINS RD STE 1165 | ||||||||
| Address2: | |||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601692050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472895727 | ||||||||
| FaxNumber: | 8478885469 | ||||||||
| Practice Location | |||||||||
| Address1: | 77 N AIRLITE ST | ||||||||
| Address2: | |||||||||
| City: | ELGIN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601234912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472895727 | ||||||||
| FaxNumber: | 8478885469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2010 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | E-7175 | AR | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | MD447713 | PA | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 036124875 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 002571140 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 30148041 | 01 | PA | AMERIHEALTH CARISTAS | OTHER | 9606680 | 01 | PA | AETNA | OTHER | 1801119730 | 01 | PA | UNITED HEALTH CARE | OTHER | 036.124875 | 01 | IL | STATE LICENSE | OTHER | 102786865-0001 | 05 | PA | MEDICAID | 1801119730 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 1027868650001 | 01 | PA | COVENTRY | OTHER | 8234481 | 01 | PA | CIGNA/GREATWEST HEALTHCARE | OTHER | 830726 | 01 | PA | FPH | OTHER |