Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mysore N Shivaram MD SC

Organization Addiction Medicine (Internal Medicine) Physician · NPI 1679888341

Mysore N Shivaram MD SC is an Addiction Medicine (Internal Medicine) Physician in Berwyn, Illinois. Licensed in Illinois. Registered with an NPI since 2010.

Licensed in
IL
In the registry since
2010

Practice location Address checks out

6901 Cermak Rd
Berwyn, IL 60402-2160
Phone: (708) 484-5660
Fax: (708) 484-0194
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Internal Medicine) Physician (primary) Taxonomy 207RA0401X · Licence 036044121 (IL)

Record details

NPI number1679888341
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mysore Shivaram — Physician · (708) 484-5660
NPI enumeratedAugust 18, 2010
Last updated in NPPESOctober 15, 2014
Mailing address6901 Cermak Rd, Berwyn, IL 60402-2160