Individual
BHAVEN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 BUSSE HWY, PARK RIDGE, IL 60068-2302
(847) 759-4770
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-109453
IL
207RP1001X
Pulmonary Disease Physician
Primary
036-109453
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109453
—
IL
Enumeration date
07/14/2006
Last updated
07/26/2022
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