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NPI Code Detail

MEDICARE: SHALIN SHAH M.D.

MEDICARE: SHALIN SHAH M.D.
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
1207R00000XInternal Medicine Physician125-066330IL
2207R00000XInternal Medicine Physician036144283IL

Other Identifiers

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

General Provider Information

NPI Number : 1215324462
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALIN SHAH M.D.
Provider Business Mailing Address
First Line : PO BOX 713260
Second Line :
City : CHICAGO
State : IL
Zip : 60677-1260
Country : US
Telephone Number : 630-469-9200
Fax Number :
Provider Business Practice Location Address
First Line : 12004 S ROUTE 59 UNIT 100
Second Line :
City : PLAINFIELD
State : IL
Zip : 60585-5108
Country : US
Telephone Number : 630-364-7850
Fax Number : 630-432-6604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2015
Last Update Date : 08/18/2023

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