Individual
DR. SHIVANI PANKAJ SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12 SALT CREEK LN, SUITE 106, HINSDALE, IL 60521-8605
(630) 856-2731
(630) 323-0260
Mailing address
12 SALT CREEK LN, SUITE 106, HINSDALE, IL 60521-8605
(630) 856-2731
(630) 323-0260
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
036120677
IL
282NC2000X
Children's Hospital
036.120677
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
399980
MEDICARE GROUP PTAN
—
Enumeration date
06/10/2008
Last updated
02/25/2013
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