Organization
DEVINA SHAH SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVINA SHAH MD (OWNER)
(773) 468-9000
Entity
Organization
Contact information
Practice address
2315 E 93RD ST, SUITE 340, CHICAGO, IL 60617-3936
(773) 468-9000
Mailing address
2315 E 93RD ST, SUITE 340, CHICAGO, IL 60617-3936
(773) 468-9000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036059687
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036059687
—
IL
Enumeration date
04/04/2011
Last updated
04/04/2011
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