MEDICARE: SHIFA NEPHROLOGY ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1487955878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIFA NEPHROLOGY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	1544 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5236
Country	:	US
Telephone Number	:	773-232-2300
Fax Number	:	773-232-2301

Provider Business Practice Location Address
First Line	:	1544 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5236
Country	:	US
Telephone Number	:	773-232-2300
Fax Number	:	773-232-2301

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FARHEEN SHAH-KHAN
Credential	:
Telephone Number	:	773-232-2300

Provider Enumeration Date	:	11/16/2010
Last Update Date	:	12/31/2025

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