Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 070013762 | IL |
NPI | 1215388244 |
---|---|
Provider Name | Mrs. Shefali Chandnani |
First Address | Bloomingdale, IL 60108-1036 |
Second Address | Bloomingdale, IL 60108-1036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2016 |
Last Update Date | 30/06/2016 |