Physician Compare National (NPI:1912997743)

HEALTHCARE PROVIDER: AHMED SHAFI M.D.

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

Individual Professional Information
NPI	1912997743
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739131582
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050221000207
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SHAFI
	Individual professional last name
Provider First Name	AHMED
	Individual professional first 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	1974
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PODIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PODIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	45 W 111TH ST
	Group Practice or individual's line 1 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606284200
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROSELAND COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y