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NPI Code Detail

MEDICARE: YATIN SHAH M.D.

MEDICARE: YATIN 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 Physician036067943IL

General Provider Information

NPI Number : 1235108911
Entity Type Code : Individual
Provider Name (Legal Business Name) : YATIN SHAH M.D.
Provider Business Mailing Address
First Line : 2025 S CHICAGO ST
Second Line :
City : JOLIET
State : IL
Zip : 60436-3172
Country : US
Telephone Number : 815-726-2200
Fax Number : 815-727-1442
Provider Business Practice Location Address
First Line : 2025 S CHICAGO ST
Second Line :
City : JOLIET
State : IL
Zip : 60436-3172
Country : US
Telephone Number : 815-726-2200
Fax Number : 314-536-8783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 08/14/2025

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