Individual
DR. DILIP SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6134 S HARLEM AVE, SUMMIT, IL 60501-1625
(708) 458-0102
Mailing address
PO BOX 470, 6134 S HARLEM AVE, SUMMIT, IL 60501-0470
(708) 458-0102
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036.067272
IL
174400000X
Specialist
336.021940
IL
207R00000X
Internal Medicine Physician
Primary
036057272
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057272
—
IL
01
—
111910586C
RAILROAD MEDICARE
IL
01
—
31600233
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/31/2006
Last updated
12/16/2016
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