Individual
MINTI VIJAY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-6895
Mailing address
251 E HURON ST, CHICAGO, IL 60611-2908
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125074968
IL
207PH0002X
Hospice and Palliative Medicine (Emergency Medicine) Physician
Primary
036160929
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
06/20/2022
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