Individual
DR. JENNIFER SHASTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 W WASHINGTON ST STE 1801, CHICAGO, IL 60602-3430
(312) 695-8106
(312) 694-1340
Mailing address
111 W WASHINGTON ST STE 1801, CHICAGO, IL 60602-3430
(312) 695-8106
(312) 694-1340
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036152257
IL
207N00000X
Dermatology Physician
125069308
IL
Other
Enumeration date
05/12/2016
Last updated
10/06/2020
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