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NPI Code Detail

MEDICARE: JANAKI MUKUND SHAH MD

MEDICARE: JANAKI MUKUND 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
1207RG0100XGastroenterology Physician036.175400IL
2207RG0100XGastroenterology Physician01096400AIN

General Provider Information

NPI Number : 1801456942
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANAKI MUKUND SHAH MD
Provider Business Mailing Address
First Line : 1400 S MICHIGAN AVE APT 1203
Second Line :
City : CHICAGO
State : IL
Zip : 60605-3720
Country : US
Telephone Number : 312-767-3244
Fax Number :
Provider Business Practice Location Address
First Line : 10855 VIRGINIA ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-0210
Country : US
Telephone Number : 317-507-2958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2019
Last Update Date : 06/25/2025

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