OrganizationActive
Mysore N Shivaram MD Sc
NPI 1679888341 · Addiction Medicine (Internal Medicine) Physician · Berwyn, IL
Provider details
- NPI number
- 1679888341
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mysore Shivaram, Physician(708) 484-5660
- License
- 036044121 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
6901 Cermak Rd
Berwyn, IL 60402-2160
Phone: (708) 484-5660
Fax: (708) 484-0194
Approximate (ZIP-level) locationGet directions
Mailing address
6901 Cermak Rd
Berwyn, IL 60402-2160
Registry dates
- Enumerated
- 2010-08-18
- Last updated
- 2014-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.