Individual
MAULIN G SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
107 WATTERS DR, DWIGHT, IL 60420
(815) 584-4334
(815) 584-4364
Mailing address
107 WATTERS DR, DWIGHT, IL 60420-1280
(815) 584-4334
(815) 584-4364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036141076
IL
Other
Enumeration date
03/28/2013
Last updated
02/25/2019
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