MEDICARE: SHABBIR A SHAIKH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036075000	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110076104	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053337568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHABBIR A SHAIKH MD

Provider Business Mailing Address
First Line	:	5003 N ILLINOIS ST STE 2
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-3419
Country	:	US
Telephone Number	:	618-233-5000
Fax Number	:	618-233-5040

Provider Business Practice Location Address
First Line	:	5003 N ILLINOIS ST STE 2
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-3419
Country	:	US
Telephone Number	:	618-233-5000
Fax Number	:	618-233-5040

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	10/15/2024

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Directions to “ SHABBIR A SHAIKH MD” Practice Location

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