Individual
DR. KALPANA TUSHAR SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2025 S CHICAGO ST, JOLIET, IL 60436-3172
(815) 727-5813
(815) 727-7260
Mailing address
1 MICHELE CT, BOLINGBROOK, IL 60490-4921
(815) 609-7209
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19025713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9176397
—
IL
Enumeration date
10/24/2005
Last updated
12/02/2013
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