Individual
DR. BHADRA SHAH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
5906 N MILWAUKEE AVE, CHICAGO, IL 60646-5420
(773) 774-7300
Mailing address
5906 N MILWAUKEE AVE, CHICAGO, IL 60646-5420
(773) 774-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632789
BC #
IL
Enumeration date
05/11/2006
Last updated
07/08/2007
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