Provider Demographics
NPI:1043576341
Name:FALITZ, SHAWN MARTEN (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MARTEN
Last Name:FALITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 EBBTIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5019
Mailing Address - Country:US
Mailing Address - Phone:516-978-0574
Mailing Address - Fax:
Practice Address - Street 1:4201 W MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8409
Practice Address - Country:US
Practice Address - Phone:815-344-5000
Practice Address - Fax:815-344-3347
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036167291207L00000X
GA98265207L00000X
OH131338207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology