Healthcare Provider Details

I. General information

NPI: 1851100481
Provider Name (Legal Business Name): SHANZEH AFTAB PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N RIVER RD STE 310
DES PLAINES IL
60016-1272
US

IV. Provider business mailing address

150 N RIVER RD STE 310
DES PLAINES IL
60016-1272
US

V. Phone/Fax

Practice location:
  • Phone: 847-795-0900
  • Fax: 847-795-0955
Mailing address:
  • Phone: 847-795-0900
  • Fax: 847-795-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number085011980
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: