# ASHOK C SHAH MDPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790079234
- **Authorized official:** ASHOK C SHAH (M.D)
- **Authorized official phone:** (773) 769-3338

## Contact information

- **Practice address:** 1624 W MONTROSE AVE, CHICAGO, IL 60613-1214
- **Practice address phone:** (773) 769-3338
- **Practice address fax:** (773) 769-5568
- **Mailing address:** 1624 W MONTROSE AVE, CHICAGO, IL 60613-1214
- **Mailing address phone:** (773) 769-3338
- **Mailing address fax:** (773) 769-5568

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036064449 | IL | Yes |

## Other

- **Enumeration date:** 06/01/2011
- **Last updated:** 06/01/2011