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General NPI Number Information
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NPI Number | 1750641692
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Entity Type | Individual
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Provider Name | ASHKA TRIVEDI DPM
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Gender | Female
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 3471 GREEN BAY RD
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3090
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Country | US
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Telephone | 847-473-4357
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Fax | 847-578-3269
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Provider Business Mailing Address
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Address Line | 836 W WELLINGTON AVE RM. 7315
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City | CHICAGO
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State | IL
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Zip | 60657-5147
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Country | US
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Telephone |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016005586
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License Number State | IL
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