Individual
KRISHNA SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5673
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1250082613
IL
Other
Enumeration date
04/04/2023
Last updated
07/12/2023
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