Healthcare Provider Details

I. General information

NPI: 1982409090
Provider Name (Legal Business Name): SHAH-NI-4 INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 E ROOSEVELT RD
LOMBARD IL
60148-4745
US

IV. Provider business mailing address

8605 N SHERMER RD
NILES IL
60714-2140
US

V. Phone/Fax

Practice location:
  • Phone: 630-376-4999
  • Fax: 630-376-1025
Mailing address:
  • Phone: 224-251-8432
  • Fax: 224-251-8319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: RAQIB SHAHZAD
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 224-251-8432