MEDICARE: DR. SAPANA K SHAH MD

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	207P00000X	Emergency Medicine Physician	036-111488	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508966359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAPANA K SHAH MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2114
Fax Number	:	847-570-1223

Provider Business Practice Location Address
First Line	:	2650 RIDGE AVE
Second Line	:	EVANSTON HOSPITAL
City	:	EVANSTON
State	:	IL
Zip	:	60201-1718
Country	:	US
Telephone Number	:	847-570-2114
Fax Number	:	847-570-1223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	04/21/2026

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