Individual
MRS. CHANDRIKA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 E 51ST STREET, PROVIDENT HOSPITAL OF COOK COUNTY DEPT OF GEN SURGERY, CHICAGO, IL 60615
(312) 572-2664
(312) 572-2681
Mailing address
500 E 51ST ST, PROVIDENT HOSPITAL OF COOK COUNTY, DEPT OF SURGERY, CHICAGO, IL 60615-2400
(312) 572-2664
(312) 572-2681
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-001953
IL
363AS0400X
Surgical Physician Assistant
MS0930241
IL
Other
Enumeration date
08/03/2005
Last updated
04/30/2021
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