Individual
KHUSHBU SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2424 W PETERSON AVE, CHICAGO, IL 60659-4100
(773) 761-0300
Mailing address
2424 W PETERSON AVE, CHICAGO, IL 60659-4100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
319.018163
IL
Other
Enumeration date
07/13/2012
Last updated
02/10/2022
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