Individual
NISHA J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, DMSC
Contact information
Practice address
911 N ELM ST STE 128, HINSDALE, IL 60521-3640
(630) 856-7460
Mailing address
265 CAREY DR, ROSELLE, IL 60172-4908
(630) 770-2888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009076
IL
Other
Enumeration date
12/09/2022
Last updated
04/29/2025
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