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General NPI Number Information
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NPI Number | 1043638380
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Entity Type | Organization
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Legal Business Name | ARJAV CORPORATION
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 6367 FREMONT DR
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City | HANOVER PARK
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State | IL
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Zip | 60133-4950
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Country | US
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Telephone | 630-863-5464
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Fax | 630-448-6687
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Provider Business Mailing Address
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Address Line | 425 E EUCLID AVE
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City | MT PROSPECT
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State | IL
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Zip | 60056-1226
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Country | US
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Telephone | 630-863-5464
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Fax | 630-448-6687
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Authorized Official
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Title or Position | CHIROPRACTOR/PRESIDENT
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Name | DR. AVANI SHAH
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Credential | D.C.
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Telephone | 630-863-5464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038011279
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License Number State | IL
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