Provider Demographics
NPI:1710090683
Name:HAVRON, SHILPI SHAH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:SHILPI
Middle Name:SHAH
Last Name:HAVRON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:SHILPI
Other - Middle Name:BIPIN
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR
Mailing Address - Street 2:STE 240
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5745
Mailing Address - Country:US
Mailing Address - Phone:708-236-2700
Mailing Address - Fax:708-409-5179
Practice Address - Street 1:1221 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1404
Practice Address - Country:US
Practice Address - Phone:630-859-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.015403225100000X
ORPT60951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04515143OtherBCBS PROVIDER#
IL0727500001Medicare NSC
IL205036002Medicare PIN
IL208010002Medicare PIN