Healthcare Provider Details

I. General information

NPI: 1881806784
Provider Name (Legal Business Name): VEERAL SHETH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 159TH ST SUITE A
OAK FOREST IL
60452-2776
US

IV. Provider business mailing address

6320 159TH ST SUITE A
OAK FOREST IL
60452-2776
US

V. Phone/Fax

Practice location:
  • Phone: 708-687-2222
  • Fax: 708-687-3829
Mailing address:
  • Phone: 708-687-2222
  • Fax: 708-687-3829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036120177
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: