Provider Demographics
NPI:1063702041
Name:SHROFF, ANAR K (DPT)
Entity type:Individual
Prefix:
First Name:ANAR
Middle Name:K
Last Name:SHROFF
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 RAES CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-2081
Mailing Address - Country:US
Mailing Address - Phone:708-209-5470
Mailing Address - Fax:
Practice Address - Street 1:1807 RAES CREEK DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-2081
Practice Address - Country:US
Practice Address - Phone:708-209-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014518225100000X
IL070024951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist