Individual
SHAHAAB UDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(812) 944-7701
(812) 981-6505
Mailing address
3 ERIE CT, SUITE L-700, OAK PARK, IL 60302-2519
(708) 763-1222
(708) 763-1471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125058873
IL
208M00000X
Hospitalist Physician
01073189B
IN
208M00000X
Hospitalist Physician
036131145
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036131145
STATE LICENSE
IL
05
—
201187680
—
IN
Enumeration date
07/06/2010
Last updated
02/08/2023
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