Individual
RAVI M. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7543 183RD ST, TINLEY PARK, IL 60477-6208
(708) 263-2000
(708) 263-2023
Mailing address
7900 ROLLINS RD STE 1400, GURNEE, IL 60031-1512
(847) 866-7846
(847) 866-7846
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.070237
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036.149951
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326579103
—
IL
Enumeration date
03/23/2017
Last updated
05/06/2024
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