Provider Demographics
NPI:1578664728
Name:SHETH, RITEN HARSHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:RITEN
Middle Name:HARSHAD
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 1:3077 W JEFFERSON ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5262
Mailing Address - Country:US
Mailing Address - Phone:815-744-6722
Mailing Address - Fax:815-744-6733
Practice Address - Street 1:3077 W JEFFERSON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5262
Practice Address - Country:US
Practice Address - Phone:815-744-6722
Practice Address - Fax:815-744-6733
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095085207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095085OtherLICENCE NUMBER
IL036095085Medicaid
IL036095085OtherLICENCE NUMBER