Individual
MANSI SHETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
80 TEMPLETON DR, OSWEGO, IL 60543-7000
(630) 554-3456
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 355-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-132276
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036132276
—
IL
Enumeration date
06/25/2009
Last updated
12/29/2015
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