Provider Demographics
NPI:1528643707
Name:SHAH, ANKUR C (DC)
Entity type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:C
Last Name:SHAH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38W641 BONNIE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6022
Mailing Address - Country:US
Mailing Address - Phone:630-433-7947
Mailing Address - Fax:
Practice Address - Street 1:1585 BARRINGTON RD.
Practice Address - Street 2:DOB 2 SUITE 601
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-490-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty