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Individual

MS. SHEFALI SURESH GANDHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MASTERS

Contact information

Practice address
300 RIDGE RD, MUNSTER, IN 46321-1528
(219) 836-0027
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009765A
IN
2251G0304X
Geriatric Physical Therapist
05009765A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201055610
IN
01
P01061953
MEDICARE RAILROAD
IN
Enumeration date
10/13/2010
Last updated
09/10/2012
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