Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Krishin Shivdasani, MDSTUDENT

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1912656562

Krishin Shivdasani, MDSTUDENT is a Student in an Organized Health Care Education/Training Program in Maywood, Illinois. Licensed in Illinois. Registered with an NPI since 2022.

Licensed in
IL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (516) 242-5027
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Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 125.083677 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (IL)

Record details

NPI number1912656562
Entity typeIndividual (Type 1)
GenderMale
Credentials MDSTUDENT
Sole proprietorNo
NPI enumeratedMarch 21, 2022
Last updated in NPPESMay 22, 2024
Certification dateMay 22, 2024
Mailing address2160 S 1st Ave, Maywood, IL 60153-3328

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