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NPI Code Detail

MEDICARE: ALPA PATEL SHAH D.O.

MEDICARE:   ALPA PATEL 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
1208000000XPediatrics Physician5101020539MI
2208000000XPediatrics Physician75267WI
3390200000XStudent in an Organized Health Care Education/Training ProgramMI
4390200000XStudent in an Organized Health Care Education/Training Program
5208000000XPediatrics PhysicianOS019284PA

Other Identifiers

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

General Provider Information

NPI Number : 1649511387
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALPA PATEL SHAH D.O.
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 16985 W BLUEMOUND RD
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-5909
Country : US
Telephone Number : 262-641-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2013
Last Update Date : 05/27/2026

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Directions to “ ALPA PATEL SHAH D.O.” Practice Location

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