Individual
NIDHI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS,MDS
Contact information
Practice address
6800 MAIN ST, DOWNERS GROVE, IL 60516-3493
(630) 969-5350
Mailing address
2024 N RACINE AVE APT A, CHICAGO, IL 60614-4067
(631) 353-9404
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.032810
IL
1223P0300X
Periodontics
Primary
021.003060
IL
Other
Enumeration date
10/02/2014
Last updated
11/16/2022
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