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NPI Code Detail

MEDICARE: DR. NIRANJANA SHAH M.D.

MEDICARE: DR. NIRANJANA 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 Physician036078000IL

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 : 1316910250
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NIRANJANA SHAH M.D.
Provider Business Mailing Address
First Line : 7101 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1903
Country : US
Telephone Number : 773-763-6364
Fax Number : 773-792-9119
Provider Business Practice Location Address
First Line : 7101 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1903
Country : US
Telephone Number : 773-763-6364
Fax Number : 773-792-9119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 06/12/2013

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