Individual
DR. PAVITRA KOTINI-SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
914 S WOOD ST, CHICAGO, IL 60612-7337
(248) 898-2001
Mailing address
808 S WOOD ST # MC724, CHICAGO, IL 60612-7300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036134809
IL
Other
Enumeration date
07/05/2011
Last updated
04/03/2019
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