Provider Demographics
NPI:1174263644
Name:VENKATESH, SHUBHASHRI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHUBHASHRI
Middle Name:
Last Name:VENKATESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHUBHA
Other - Middle Name:
Other - Last Name:VENKATESH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5459 W LELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3510
Mailing Address - Country:US
Mailing Address - Phone:312-545-8166
Mailing Address - Fax:
Practice Address - Street 1:2801 W BANCROFT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3390
Practice Address - Country:US
Practice Address - Phone:800-586-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program