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Individual

NICHOLAS MAHESH SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
20201 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461-1010
(708) 679-2160
(708) 679-2161
Mailing address
1021 COURT ST, SUITE B, PEKIN, IL 61554-4802
(309) 642-6705

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
036135679
IL
207RN0300X
Nephrology Physician
4301097605
MI
208M00000X
Hospitalist Physician
Primary
036135679
IL

Other

Enumeration date
09/12/2007
Last updated
07/18/2018
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