Individual
DR. HASIN SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 N MAIN STREET, ST ELMO, IL 62458
(618) 829-3200
(618) 829-3970
Mailing address
515 N MAIN STREET, ST ELMO, IL 62458
(618) 829-3200
(618) 829-3970
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036053206
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002600030
BCBS
—
05
—
036053206
—
IL
01
—
371026381
HL
—
Enumeration date
09/01/2006
Last updated
09/13/2011
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