Provider Demographics
NPI:1346747185
Name:SHETH, UJASH (MD)
Entity Type:Individual
Prefix:MR
First Name:UJASH
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 E ERIE STREET, 13TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-472-6488
Mailing Address - Fax:
Practice Address - Street 1:251 EAST HURON STREET
Practice Address - Street 2:NORTHWESTERN MEMORIAL HOSPITAL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-926-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-11-28
Deactivation Date:2018-11-16
Deactivation Code:
Reactivation Date:2018-11-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program