Individual
DR. KUSHAL DEEPAK SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E 75TH ST STE 105, NAPERVILLE, IL 60565-1411
(630) 933-1700
(630) 933-6240
Mailing address
101 E 75TH ST STE 105, NAPERVILLE, IL 60565-1411
(630) 933-1700
(630) 933-6240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036152184
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2017
Last updated
11/02/2020
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