Physician Compare National (NPI:1811080716)

HEALTHCARE PROVIDER: MANZOOR HUSSAIN SHAH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1811080716
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5193617744
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040327000236
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHAH
	Individual professional last name
Provider First Name	MANZOOR
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PULMONARY DISEASE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS), PULMONARY DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1479 RING RD
	Group Practice or individual's line 1 address
City	CALUMET CITY
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	604095459
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140181
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTH SHORE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150004
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FRANCISCAN ST. MARGARET HEALTH HAMMOND
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140048
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ADVOCATE TRINITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y