Healthcare Provider Details

I. General information

NPI: 1922927656
Provider Name (Legal Business Name): ARYA A SHAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ARROWWOOD CT
STREAMWOOD IL
60107-1907
US

IV. Provider business mailing address

15 ARROWWOOD CT
STREAMWOOD IL
60107-1907
US

V. Phone/Fax

Practice location:
  • Phone: 630-415-4496
  • Fax:
Mailing address:
  • Phone: 630-415-4496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: