Individual
RAKESH J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
116 N DODGE ST STE 5, BURLINGTON, WI 53105-1963
(414) 773-4312
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
036117138
IL
2084P0800X
Psychiatry Physician
Primary
53943
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012176
—
WI
Enumeration date
08/12/2006
Last updated
09/17/2025
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