Individual
SHRUTI ANTARIX KOTHADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 BROOKDALE RD, NAPERVILLE, IL 60563-2126
(630) 416-6565
Mailing address
12242 SILVER MAPLE, HOMER GLEN, IL 60491-9216
(708) 870-0345
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007645
IL
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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