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NPI Code Detail

MEDICARE: DR. RINKU H SHAH D.O.

MEDICARE: DR. RINKU H SHAH D.O.
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
1390200000XStudent in an Organized Health Care Education/Training ProgramIL
2207Q00000XFamily Medicine Physician036.138553IL

General Provider Information

NPI Number : 1528325321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RINKU H SHAH D.O.
Provider Business Mailing Address
First Line : 1605 S MICHIGAN AVE UNIT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60616-1209
Country : US
Telephone Number : 312-535-5770
Fax Number : 312-535-5770
Provider Business Practice Location Address
First Line : 1605 S MICHIGAN AVE UNIT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60616-1209
Country : US
Telephone Number : 312-535-5770
Fax Number : 312-535-5770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2012
Last Update Date : 02/25/2021

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