Organization
YATIN M SHAH MD SC
Active
Other names
primary care joliet
Organization subpart
No
Provider details
NPI number
Authorized official
MITI G SHAH (PRACTICE MANAGER)
(815) 726-2200
Entity
Organization
Contact information
Practice address
2025 S CHICAGO ST, JOLIET, IL 60436-3172
(815) 726-2200
(815) 727-1442
Mailing address
2025 S CHICAGO ST, JOLIET, IL 60436-3172
(815) 726-2200
(815) 727-1442
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
209005700
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006800
APN LICENSE
IL
Enumeration date
09/15/2006
Last updated
10/19/2018
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