Individual
HARENDRA P. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6349, N FAIRFIELD AVENUE, PRISM MEDICAL CENTER, CHICAGO, IL 60659-1705
(773) 262-1300
(773) 262-1184
Mailing address
6349, N FAIRFIELD AVENUE, PRISM MEDICAL CENTER, CHICAGO, IL 60659-1705
(773) 262-1300
(773) 262-1184
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085-001700
IL
Other
Enumeration date
08/02/2005
Last updated
10/25/2024
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