Individual
HANIT U SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
27650 FERRY RD STE 110, WARRENVILLE, IL 60555-3846
(630) 315-6543
(630) 315-6537
Mailing address
815 MAIN ST STE A, PEORIA, IL 61602-1080
(309) 672-4977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036157704
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
036157704
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125.071495
LICENSE
—
Enumeration date
06/29/2017
Last updated
03/05/2026
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