Individual
NIKITA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
62 OAKBROOK CTR, OAK BROOK, IL 60523-1810
(630) 243-5224
Mailing address
284 SOUTHGATE DR, VERNON HILLS, IL 60061-2955
(847) 863-0035
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011139
IL
Other
Enumeration date
07/27/2017
Last updated
07/27/2017
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