Individual
SUSHIL A SHETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 INGALLS DR, HARVEY, IL 60426-3558
(630) 321-0097
(630) 321-0909
Mailing address
PO BOX 157, WILLOW SPRINGS, IL 60480-0157
(630) 321-0097
(630) 321-0909
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01044948A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
036081476
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081476
—
IL
01
—
1626060
BLUE SHIELD
IL
01
—
364228422
COMMERCIAL INSURANCE
IL
Enumeration date
10/12/2006
Last updated
09/07/2023
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