Provider Demographics
NPI:1922168095
Name:SANGHVI, NISHA S
Entity Type:Individual
Prefix:MRS
First Name:NISHA
Middle Name:S
Last Name:SANGHVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NISHA
Other - Middle Name:
Other - Last Name:SAMPAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2604 MAPLESIDE LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9104
Mailing Address - Country:US
Mailing Address - Phone:630-566-8658
Mailing Address - Fax:630-559-8658
Practice Address - Street 1:2604 MAPLESIDE LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9104
Practice Address - Country:US
Practice Address - Phone:630-566-8658
Practice Address - Fax:630-559-8658
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-007535225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist