Individual
RICKY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01072947A
IN
207L00000X
Anesthesiology Physician
Primary
036119458
IL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
01072947A
IN
Other
Enumeration date
08/26/2008
Last updated
09/26/2024
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