Healthcare Provider Details

I. General information

NPI: 1437073251
Provider Name (Legal Business Name): RAJVI SHROFF DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W LAKE ST STE 300
ADDISON IL
60101-2564
US

IV. Provider business mailing address

978 GARNET LN
MONTGOMERY IL
60538-4148
US

V. Phone/Fax

Practice location:
  • Phone: 847-201-4021
  • Fax:
Mailing address:
  • Phone: 630-827-2129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.037432
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: