Individual
SHAKELLAH AMINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 456-7601
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 456-7601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125066654
IL
207Q00000X
Family Medicine Physician
Primary
20596
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101161956
—
WI
Enumeration date
05/27/2015
Last updated
11/19/2021
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