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Individual

AVANI VINOD SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
630 N STATE ST APT 1502, CHICAGO, IL 60654
(847) 858-3448
Mailing address
630 N STATE ST APT 1502, CHICAGO, IL 60654-5549
(317) 777-6644

Taxonomy

Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
01075707
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201315270
IN
Enumeration date
06/25/2009
Last updated
07/25/2018
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