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General NPI Number Information
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NPI Number | 1659576536
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Entity Type | Individual
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Provider Name | TEJAL UDAY SHAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 10370 HALIGUS RD STE 117
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City | HUNTLEY
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State | IL
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Zip | 60142-9582
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Country | US
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Telephone | 815-344-3900
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Fax | 847-802-7207
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Provider Business Mailing Address
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Address Line | 10370 HALIGUS RD STE 117
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City | HUNTLEY
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State | IL
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Zip | 60142-9582
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Country | US
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Telephone | 815-344-3900
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Fax | 847-802-7207
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 53296-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036147983
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License Number State | IL
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