Organization
VIBHAKAR S SHAH M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIBHAKAR S SHAH M.D. (OWNER)
(847) 249-0167
Entity
Organization
Contact information
Practice address
222 S GREENLEAF ST, SUITE #109, GURNEE, IL 60031-5705
(847) 249-0167
(847) 249-0717
Mailing address
222 S GREENLEAF ST, SUITE #109, GURNEE, IL 60031-5705
(847) 249-0167
(847) 249-0717
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Enumeration date
09/06/2007
Last updated
01/22/2008
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