Organization
SHIFA DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARHEEN M SHAH-KHAN M.D. (PRESIDENT)
(773) 423-6400
Entity
Organization
Contact information
Practice address
1540 W. CHICAGO AVE, CHICAGO, IL 60642
(773) 423-6400
(773) 423-8440
Mailing address
PO BOX 597315, CHICAGO, IL 60659-7315
(773) 423-6400
(773) 423-8440
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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