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General NPI Number Information
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NPI Number | 1962767525
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Entity Type | Individual
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Provider Name | PARISHA SHAH O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST STE 135
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City | CHICAGO
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State | IL
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Zip | 60622-2967
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Country | US
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Telephone | 737-376-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 901 W MADISON ST UNIT 601
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City | CHICAGO
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State | IL
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Zip | 60607-3371
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18003751A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010586
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License Number State | IL
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