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NPI Code Detail

MEDICARE: DR. VINEET PURUSHOTTAM SHAH DO, MPH

MEDICARE: DR. VINEET PURUSHOTTAM SHAH DO, MPH
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
1207X00000XOrthopaedic Surgery Physician036-116622IL

General Provider Information

NPI Number : 1699868455
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VINEET PURUSHOTTAM SHAH DO, MPH
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number : 847-390-4757
Provider Business Practice Location Address
First Line : 3021 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4419
Country : US
Telephone Number : 872-843-0550
Fax Number : 872-873-9070
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 12/16/2022

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