Organization
A. N. SHAH MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHVIN N SHAH MD (OWNER)
(773) 468-9000
Entity
Organization
Contact information
Practice address
2315 E 93RD ST STE 340, CHICAGO, IL 60617-3948
(773) 468-9000
(847) 587-6113
Mailing address
3040 SCOTT CRES, FLOSSMOOR, IL 60422-1728
(773) 468-9000
(847) 587-6113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036058180
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058180
—
IL
Enumeration date
08/03/2006
Last updated
11/17/2009
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