MEDICARE: SHRENIK D SHAH PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	051303781	IL

General Provider Information

NPI Number	:	1972254621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHRENIK D SHAH PHARM D

Provider Business Mailing Address
First Line	:	702 BROUGHAM LN
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-2677
Country	:	US
Telephone Number	:	630-965-4387
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 W ROUTE 34
Second Line	:
City	:	PLANO
State	:	IL
Zip	:	60545-9607
Country	:	US
Telephone Number	:	630-552-3104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2022
Last Update Date	:	01/14/2022

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Directions to “ SHRENIK D SHAH PHARM D” Practice Location

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