| NPI Details | |
|---|---|
| NPI | 1700813771 |
| Gender | Female |
| Enumeration Date | 06/27/2006 |
| Last Updated | 06/18/2015 |
| Entity Type | Individual |
| Active | Over 10 years ago |
| Practice Location | |
|---|---|
| 3825 HIGHLAND AVE TOWER 1 SUITE 2F DOWNERS GROVE IL, 60515-1552, US |
|
| Phone | (630) 852-3762 |
| Fax | (630) 852-4087 |
| Business Location | |
|---|---|
| 3825 HIGHLAND AVE TOWER 1 SUITE 2F DOWNERS GROVE IL, 60515-1552, US |
|
| Phone | (630) 852-3762 |
| Fax | (630) 829-6818 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207V00000X |
| License State | Illinois |
| License Number | 036107104 |
| Remove 1700813771 NPI Number | |
According to our database, Shamita V Bansore MD NPI is 1700813771, taxonomy code is 207V00000X and license number is 036107104, license state is located at Illinois. Shamita V Bansore MD physically located at 3825 Highland Ave, Downers Grove IL, 60515-1552. NPI Number Shamita V Bansore MD has the Individual type.
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1700813771 NPI number is provided on an as is basis without warranty of any kind. 1700813771 is maintained by the National Plan & Provider Enumeration System. The contents of Shamita V Bansore MD are for informational purposes only.
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