Individual
BHARAT KANTILAL SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4025 N WESTERN AVE, CHICAGO, IL 60618-3726
(773) 271-6622
(773) 271-6801
Mailing address
2740 W FOSTER AVE STE 101, CHICAGO, IL 60625-3547
(773) 271-6622
(773) 271-6801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36-472670
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034047260
—
IL
01
—
110169119
RAILROAD MEDICARE
—
Enumeration date
05/27/2006
Last updated
04/20/2022
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