Basic Information
Provider Information
NPI: 1821257833
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DASMUNSHI
FirstName: NEHA
MiddleName: SHETH
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SHETH
OtherFirstName: NEHA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2160 S FIRST AVE
Address2:  
City: MAYWOOD
State: IL
PostalCode: 601533328
CountryCode: US
TelephoneNumber: 7082169169
FaxNumber:  
Practice Location
Address1: 2160 S FIRST AVE
Address2:  
City: MAYWOOD
State: IL
PostalCode: 601533328
CountryCode: US
TelephoneNumber: 7082169169
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2008
LastUpdateDate: 04/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/06/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X036126855ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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