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General NPI Number Information
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NPI Number | 1588151062
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Entity Type | Individual
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Provider Name | RUNALI SHAH PT
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Gender | Female
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 2401 KANEVILLE RD STE 5
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City | GENEVA
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State | IL
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Zip | 60134-2577
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Country | US
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Telephone | 630-359-1935
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Fax |
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Provider Business Mailing Address
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Address Line | 671 TACOMA DR
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City | CAROL STREAM
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State | IL
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Zip | 60188-4743
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Country | US
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Telephone | 608-628-4612
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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