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Organization
SUNIL K. SHAH D.O, S.C
Active
Organization
SUNIL K. SHAH D.O, S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNIL K SHAH (PRESIDENT)
(815) 464-7436
Entity
Organization
Contact information
Practice address
4647 W 103RD ST STE 1I, OAK LAWN, IL 60453-4792
(708) 423-7424
Mailing address
7641 NEWFIELD LN, TINLEY PARK, IL 60477-5539
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036105759
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105759
—
IL
Enumeration date
08/05/2006
Last updated
02/12/2020
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