Healthcare Provider Details

I. General information

NPI: 1235386160
Provider Name (Legal Business Name): DIPAL CHOKSHI SHAH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIPAL CHOKSHI D.O.

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 W RAND RD STE 210
ARLINGTON HEIGHTS IL
60004-2315
US

IV. Provider business mailing address

1051 W RAND RD STE 210
ARLINGTON HEIGHTS IL
60004-2315
US

V. Phone/Fax

Practice location:
  • Phone: 847-725-8401
  • Fax: 847-454-2236
Mailing address:
  • Phone: 847-725-8401
  • Fax: 847-454-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125-051900
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: