Individual
MANZOOR HUSSAIN SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1479 RING RD, CALUMET CITY, IL 60409
(708) 891-2181
(708) 891-2188
Mailing address
1479 RING RD, CALUMET CITY, IL 60409
(708) 891-2181
(708) 891-2188
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
01031445
IN
207RP1001X
Pulmonary Disease Physician
Primary
036 049259
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036049259
—
IL
01
—
100005670B
PUBLIC AID
IN
Enumeration date
10/02/2006
Last updated
10/14/2014
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