Individual
DR. KETAN K SHELADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5109 S PULASKI RD, UNIT D, CHICAGO, IL 60632-4219
(773) 284-9844
(773) 284-9827
Mailing address
5109 S PULASKI RD, UNIT D, CHICAGO, IL 60632-4219
(773) 284-9844
(773) 284-9827
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009646
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221691
EYEMED
IL
Enumeration date
02/13/2007
Last updated
11/11/2013
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