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2401 Kaneville Rd Ste 5, Geneva, IL 60134-2577 | |
(608) 628-4612 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 2401 Kaneville Rd Ste 5, Geneva, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275312274 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Runali S Shah |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1588151062 PECOS PAC ID: 5597020180 Enrollment ID: I20180601000130 |
Provider Name | Priya Shah |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1891347241 PECOS PAC ID: 1456689876 Enrollment ID: I20190823000089 |
Mailing Address | Practice Location Address |
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671 Tacoma Dr, Carol Stream, IL 60188-4743 Ph: (608) 628-4612 | 2401 Kaneville Rd Ste 5, Geneva, IL 60134-2577 Ph: (608) 628-4612 |