Individual
DR. JAY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9555 S 52ND AVE, OAK LAWN, IL 60453-3054
(708) 422-5700
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.166794
IL
207Q00000X
Family Medicine Physician
Primary
125076251
IL
Other
Enumeration date
03/28/2020
Last updated
09/07/2023
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