Organization
K S SHAH MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA M PETERSON (OFFICE MANAGER)
(708) 799-5420
Entity
Organization
Contact information
Practice address
17680 KEDZIE AVE, STE 201, HAZEL CREST, IL 60429-2043
(708) 799-5420
(708) 799-4093
Mailing address
17680 KEDZIE AVE, STE 201, HAZEL CREST, IL 60429-2043
(708) 799-5420
(708) 799-4093
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
36-048096
IL
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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