Individual
DEVINA A SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11240 S MICHIGAN AVE, CHICAGO, IL 60628-4941
(773) 468-9000
(773) 995-9181
Mailing address
11240 S MICHIGAN AVE, CHICAGO, IL 60628-4941
(773) 468-9000
(773) 995-9181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036059687
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059687
—
IL
01
—
050013082
RAIL ROAD MEDICARE
IL
01
—
31603534
BLUE CROSS/SHIELD
IL
Enumeration date
08/03/2006
Last updated
05/26/2011
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