Individual
DR. UDAY SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9133 S STONY ISLAND AVE, CHICAGO, IL 60617-3512
(773) 221-4645
(773) 221-4849
Mailing address
9133 S STONY ISLAND AVE, CHICAGO, IL 60617-3512
(773) 221-4645
(773) 221-4849
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036057749
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057749 1
—
IL
05
—
200074090B
—
IN
Enumeration date
07/17/2006
Last updated
09/30/2011
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