Individual
DR. JAYMIN R SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(847) 837-0252
Mailing address
1600 YORK CT, MUNDELEIN, IL 60060-3371
(608) 756-6049
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
036123633
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
50065-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123633 1
—
IL
05
—
1770670408
—
WI
01
—
SHAHJAY
MERCYCARE INSURANCE
WI
Enumeration date
10/06/2006
Last updated
08/07/2012
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