RICKY J SHAH

DECATUR, IL
NPI1700216322
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085004825)
Additional Taxonomies363A00000X Physician Assistant
(Licence: NJ  25MP00586200)
Enumeration Date2013-11-18
Last Update Date2023-05-24
Business Address
MR. RICKY J SHAH PA-C
2300 N EDWARD ST
DECATUR, IL 62526
Phone number: 217-876-8121
Mailing Address
MR. RICKY J SHAH PA-C
1771 MADISON AVE
LAKEWOOD, NJ 08701-1242
Phone number: 245-323-3872