Individual
DR. FAWAD J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2380 S ELMHURST RD, MOUNT PROSPECT, IL 60056-5805
(847) 493-7392
(847) 627-4178
Mailing address
2380 S ELMHURST RD, MOUNT PROSPECT, IL 60056-5805
(847) 493-7392
(847) 627-4178
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019027741
IL
1223G0001X
General Practice Dentistry
Primary
019027741
IL
1223G0001X
General Practice Dentistry
D7933
AZ
Other
Enumeration date
07/20/2008
Last updated
09/17/2012
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