Individual
ATISH SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
342 RANDALL RD, SOUTH ELGIN, IL 60177-2261
(630) 209-3680
Mailing address
342 RANDALL RD, SOUTH ELGIN, IL 60177-2261
(630) 209-3680
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034254
IL
Other
Enumeration date
06/07/2023
Last updated
04/16/2024
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