Provider Demographics
NPI:1730747247
Name:SHANT PLLC
Entity type:Organization
Organization Name:SHANT PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-830-2060
Mailing Address - Street 1:7315 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-2616
Mailing Address - Country:US
Mailing Address - Phone:630-830-2060
Mailing Address - Fax:630-448-6687
Practice Address - Street 1:7315 CUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-2616
Practice Address - Country:US
Practice Address - Phone:630-830-2060
Practice Address - Fax:630-448-6687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty