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Individual
RUTH SUBHASH SHAH
Active
Individual
RUTH SUBHASH SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209007743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBSIL
IL
01
—
950150
MEDICARE GROUP #
IL
Enumeration date
09/01/2009
Last updated
03/23/2012
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