Individual
REBECCA GLORIA SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
1715 E 95TH ST, CHICAGO, IL 60617-4708
(773) 977-7256
Mailing address
PO BOX 1541, NORTHBROOK, IL 60065-1541
(847) 386-7744
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041459161
IL
363L00000X
Nurse Practitioner
Primary
209027158
IL
363LG0600X
Gerontology Nurse Practitioner
209.027158
IL
Other
Enumeration date
02/08/2023
Last updated
01/09/2026
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