Individual
NAMRATA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4214 N HARLEM AVE, NORRIDGE, IL 60706-1293
Mailing address
55 W CHESTNUT ST APT 2405, CHICAGO, IL 60610-7316
(440) 666-2783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011054
IL
390200000X
Student in an Organized Health Care Education/Training Program
OPT.6409
OH
Other
Enumeration date
06/29/2015
Last updated
07/21/2022
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