Individual
ALEEN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(815) 986-1363
Mailing address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
(815) 986-1363
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
XS3247245
IL
2084P0800X
Psychiatry Physician
085-005058
IL
2084P0802X
Addiction Psychiatry Physician
XS3247245
IL
363A00000X
Physician Assistant
Primary
085005058
IL
363AM0700X
Medical Physician Assistant
085-005058
IL
Other
Enumeration date
05/29/2014
Last updated
01/12/2023
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