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General NPI Number Information
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NPI Number | 1982409090
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Entity Type | Organization
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Legal Business Name | SHAH-NI-4 INC.
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 125 FAIRFIELD WAY STE 104
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1556
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Country | US
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Telephone | 224-251-8432
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Fax | 224-251-8319
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Provider Business Mailing Address
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Address Line | 8605 N SHERMER RD
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City | NILES
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State | IL
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Zip | 60714-2140
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Country | US
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Telephone | 224-251-8432
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Fax | 224-251-8319
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | RAQIB SHAHZAD
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Credential |
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Telephone | 224-251-8432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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