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General NPI Number Information
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NPI Number | 1043419328
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Entity Type | Organization
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Legal Business Name | UPENDRA C. SHAH MDSC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE SUITE # 444
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City | CHICAGO
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State | IL
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Zip | 60631-3745
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Country | US
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Telephone | 773-631-8474
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Fax | 773-631-4180
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE SUITE # 444
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City | CHICAGO
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State | IL
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Zip | 60631-3745
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Country | US
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Telephone | 773-631-8474
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Fax | 773-631-4180
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. UPENDRA C. SHAH
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Credential | M.D.
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Telephone | 773-631-8474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036057815
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License Number State |
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