Individual
DIPTI V SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
104 E ROOSEVELT RD, STE 201, WHEATON, IL 60187-5267
(630) 752-8823
Mailing address
104 E ROOSEVELT RD, STE 201, WHEATON, IL 60187-5267
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005638
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.005638
LICENSE #
IL
Enumeration date
08/10/2012
Last updated
10/29/2012
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