MEDICARE: MR. ERIC SHAH

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	183500000X	Pharmacist	051291537	IL

General Provider Information

NPI Number	:	1578499349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC SHAH

Provider Business Mailing Address
First Line	:	354 S CLYDE CT
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-5993
Country	:	US
Telephone Number	:	847-226-7738
Fax Number	:

Provider Business Practice Location Address
First Line	:	354 S CLYDE CT
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-5993
Country	:	US
Telephone Number	:	847-226-7738
Fax Number	:

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

Provider Enumeration Date	:	06/20/2026
Last Update Date	:	06/20/2026

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Directions to “ MR. ERIC SHAH ” Practice Location

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