Individual
ATUL SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
THREE SAINT ELIZABETH BLVD STE 2800, O FALLON, IL 62269-1282
(618) 233-6044
(833) 973-4218
Mailing address
THREE SAINT ELIZABETH BLVD STE 2800, O FALLON, IL 62269-1282
(618) 233-6044
(833) 973-4218
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-084332
IL
207RI0011X
Interventional Cardiology Physician
036084332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360843321
—
IL
01
—
060009694
RR MEDICARE
—
01
—
093363
HEALTH ALLIANCE
—
01
—
12487
ESSENCE
—
01
—
141631
UHC
—
01
—
189282
HEALTHLINK
—
01
—
235177
WELLCARE
—
01
—
2507202
SECURE HORIZONS
—
01
—
28281
BCBS MO
MO
01
—
37099690005
GHP
—
01
—
42767
CMR
—
01
—
E57736
MERCY
—
Enumeration date
06/28/2006
Last updated
12/30/2021
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