Provider Demographics
NPI:1508159385
Name:SHAH, CHANDNI PARIKH (MSN)
Entity Type:Individual
Prefix:
First Name:CHANDNI
Middle Name:PARIKH
Last Name:SHAH
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 LANGSTON LN
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3466
Mailing Address - Country:US
Mailing Address - Phone:609-540-8683
Mailing Address - Fax:
Practice Address - Street 1:2401 HARNISH DR STE 100
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-6846
Practice Address - Country:US
Practice Address - Phone:847-440-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000438363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health