Individual
VIPUJ A SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(312) 654-2744
Mailing address
210 S DESPLAINES ST, CHICAGO, IL 60661-5500
(312) 654-2720
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036124335
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124335
—
IL
Enumeration date
03/16/2009
Last updated
11/22/2024
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