Provider Demographics
NPI:1598190449
Name:SHAH, ASHWIN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ASHWIN
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N FOXDALE DR
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-5713
Mailing Address - Country:US
Mailing Address - Phone:773-203-6467
Mailing Address - Fax:
Practice Address - Street 1:1305 N FOXDALE DR
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-5713
Practice Address - Country:US
Practice Address - Phone:773-203-6467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51-326851835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology