Provider Demographics
NPI:1306042999
Name:BAMROLIA, SHILPA ANSHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:ANSHUL
Last Name:BAMROLIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHILPA
Other - Middle Name:MANHAR
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:257 WASHINGTON BLVD
Mailing Address - Street 2:# 1
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4140
Mailing Address - Country:US
Mailing Address - Phone:708-699-4832
Mailing Address - Fax:
Practice Address - Street 1:45 TOWER CT STE C
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3376
Practice Address - Country:US
Practice Address - Phone:847-623-3200
Practice Address - Fax:847-623-9168
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.117142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine