Individual
DISHA KUNAL SHUKLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4505 W 95TH ST, OAK LAWN, IL 60453-2621
(708) 229-9828
(708) 422-0914
Mailing address
4505 W 95TH ST, OAK LAWN, IL 60453-2621
(708) 229-9828
(708) 422-0914
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070019565
IL
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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