Provider Demographics
NPI:1194166884
Name:GAMBLE, NEHA SHAH (DC)
Entity type:Individual
Prefix:DR
First Name:NEHA
Middle Name:SHAH
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:NEHA
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:511 ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2152
Mailing Address - Country:US
Mailing Address - Phone:630-442-0057
Mailing Address - Fax:
Practice Address - Street 1:511 ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2152
Practice Address - Country:US
Practice Address - Phone:630-442-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.12391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor