Provider Demographics
NPI:1255791901
Name:SHETH, VANI (PT)
Entity type:Individual
Prefix:
First Name:VANI
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 S NAPERVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-5896
Mailing Address - Country:US
Mailing Address - Phone:630-221-0200
Mailing Address - Fax:708-491-4281
Practice Address - Street 1:1751 S NAPERVILLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-5896
Practice Address - Country:US
Practice Address - Phone:630-221-0200
Practice Address - Fax:708-491-4281
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070.022001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist