Organization
PUJA SHAH O.D, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PUJA SHAH O.D (PRESIDENT)
(773) 661-6615
Entity
Organization
Contact information
Practice address
3220 W ARMITAGE AVE, CHICAGO, IL 60647-3797
(773) 661-6615
(773) 698-7408
Mailing address
3220 W ARMITAGE AVE, CHICAGO, IL 60647-3797
(773) 661-6615
(773) 698-7408
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010366
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046.010366
—
IL
Enumeration date
08/27/2012
Last updated
08/28/2012
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