Individual
BANSARI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1447
(773) 702-6757
Mailing address
253 E DELAWARE PL APT 4G, CHICAGO, IL 60611-1750
(562) 477-1101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125057860
IL
207P00000X
Emergency Medicine Physician
Primary
A125097
CA
Other
Enumeration date
07/02/2010
Last updated
05/05/2020
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