Provider Demographics
NPI:1265942023
Name:SETH, SHEFALI BHATT (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHEFALI
Middle Name:BHATT
Last Name:SETH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 SPARTINA RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5033
Mailing Address - Country:US
Mailing Address - Phone:224-402-0366
Mailing Address - Fax:
Practice Address - Street 1:1S072 LUTHER AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4164
Practice Address - Country:US
Practice Address - Phone:630-247-8877
Practice Address - Fax:630-576-0580
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1053383125OtherDR. KIRAN DHILLON