Individual
MISS ROMA M SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
251 E HURON ST STE 5-704, CHICAGO, IL 60611-2908
(312) 695-0061
(312) 695-9013
Mailing address
251 E HURON ST STE 5-704, CHICAGO, IL 60611-2908
(312) 695-0061
(312) 695-9013
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018470
IL
363LA2200X
Adult Health Nurse Practitioner
209018470
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FO7182325
AANP
IL
Enumeration date
04/11/2018
Last updated
05/02/2023
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