MEDICARE: DR. SURESH VRAJLAL SHINGALA 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	207RI0011X	Interventional Cardiology Physician	060-003510	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	:	1740386051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SURESH VRAJLAL SHINGALA MD

Provider Business Mailing Address
First Line	:	5015 N PAULINA ST
Second Line	:	#214
City	:	CHICAGO
State	:	IL
Zip	:	60640-2756
Country	:	US
Telephone Number	:	773-784-8500
Fax Number	:	773-989-5412

Provider Business Practice Location Address
First Line	:	5015 N PAULINA ST
Second Line	:	#214
City	:	CHICAGO
State	:	IL
Zip	:	60640-2756
Country	:	US
Telephone Number	:	773-784-8500
Fax Number	:	773-989-5412

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/01/2014

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