Individual
SHREYA VASAVADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12 VINCENT CT, NAPERVILLE, IL 60565-1106
(630) 484-6127
Mailing address
12 VINCENT CT, NAPERVILLE, IL 60565-1106
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085006723
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154322
NCCPA
IL
Enumeration date
08/01/2018
Last updated
06/29/2023
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