Healthcare Provider Details

I. General information

NPI: 1679439863
Provider Name (Legal Business Name): SHIFA NURSING HOME KIDNEY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 W CHICAGO AVE
CHICAGO IL
60642-5236
US

IV. Provider business mailing address

1544 W CHICAGO AVE
CHICAGO IL
60642-5236
US

V. Phone/Fax

Practice location:
  • Phone: 773-232-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: FARHEEN M SHAH-KHAN
Title or Position: PRESIDENT
Credential:
Phone: 773-232-2300