Individual
SIMA K SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1100 JOLIET ST, SUITE 205, DYER, IN 46311-1996
(219) 864-3300
(219) 864-2569
Mailing address
1100 JOLIET ST, SUITE 205, DYER, IN 46311-1996
(219) 864-3300
(219) 864-2569
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008167A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306105
ANTHEM - APT PLUS
IN
01
—
000000320909
ANTHEM - 1ST AID PLUS
IN
01
—
000000324508
ANTHEM - MBWOUDE
IN
01
—
P00608812
RAILROAD GROUP MEMBER PTAN
IL
Enumeration date
06/07/2006
Last updated
08/18/2008
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