Provider Demographics
NPI:1609035153
Name:SHAH, BINITA SHETHNA (AUD CC/A)
Entity Type:Individual
Prefix:MRS
First Name:BINITA
Middle Name:SHETHNA
Last Name:SHAH
Suffix:
Gender:F
Credentials:AUD CC/A
Other - Prefix:MS
Other - First Name:BINITA
Other - Middle Name:MADHUSUDAN
Other - Last Name:SHETHNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:5600 W. ADDISON
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634
Mailing Address - Country:US
Mailing Address - Phone:773-725-2700
Mailing Address - Fax:773-725-2796
Practice Address - Street 1:5600 W. ADDISON
Practice Address - Street 2:SUITE 207
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634
Practice Address - Country:US
Practice Address - Phone:773-725-2700
Practice Address - Fax:773-725-2796
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000899231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist