Provider Demographics
NPI:1316183510
Name:SHAH, AVANI (DC)
Entity Type:Individual
Prefix:DR
First Name:AVANI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor