Provider Demographics
NPI:1356862460
Name:SHETH, NEHAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:NEHAL
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 S HIGHLAND AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-7131
Mailing Address - Country:US
Mailing Address - Phone:630-495-3338
Mailing Address - Fax:
Practice Address - Street 1:2340 S HIGHLAND AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-7131
Practice Address - Country:US
Practice Address - Phone:630-495-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016.005872213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist