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General NPI Number Information
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NPI Number | 1225284078
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Entity Type | Individual
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Provider Name | SHELLY AGARWAL MD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 12251 S 80TH AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1290
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Country | US
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Telephone | 708-923-4000
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Fax | 708-923-4816
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Provider Business Mailing Address
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Address Line | 12251 S 80TH AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1290
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Country | US
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Telephone | 708-923-4000
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Fax | 708-923-4816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036127769
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD-53756
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 125054706
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License Number State | IL
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