Bansore, Shamita V

Bansore, Shamita V is an individual health care provider with primary practice located at 3825 Highland Ave Tower 1 Suite 2F, Downers Grove IL 60515-1552. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Bansore, Shamita V can be contacted via phone (630) 852-3762.

Contact Information

Primary practice address
3825 Highland Ave Tower 1 Suite 2F Downers Grove IL 60515-1552
Phone: (630) 852-3762
Fax: (630) 852-4087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036107104 Illinois

Profile Details

NPI number 1700813771
LBN Legal business name Bansore, Shamita V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Jan 31st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700813771 NPPES
Illinois MEDICAID 036107104

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