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NPI Code Detail

MEDICARE: BHARAT KANTILAL SHAH MD

MEDICARE: BHARAT KANTILAL SHAH 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
1207R00000XInternal Medicine Physician36-472670IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110169119OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568419570
Entity Type Code : Individual
Provider Name (Legal Business Name) : BHARAT KANTILAL SHAH MD
Provider Business Mailing Address
First Line : 2740 W FOSTER AVE STE 101
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3547
Country : US
Telephone Number : 773-271-6622
Fax Number : 773-271-6801
Provider Business Practice Location Address
First Line : 4025 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3726
Country : US
Telephone Number : 773-271-6622
Fax Number : 773-271-6801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 04/20/2022

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