Individual
KUNJAL SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5801 BLACKSTONE AVE, LA GRANGE HIGHLANDS, IL 60525-7108
(708) 482-0904
Mailing address
5801 BLACKSTONE AVE, LA GRANGE HIGHLANDS, IL 60525-7108
(708) 482-0904
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-015057
IL
Other
Enumeration date
10/27/2016
Last updated
12/17/2021
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