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Individual

EJAZ SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
315 W CARPENTER ST, SPRINGFIELD, IL 62702-4901
(217) 545-8000
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036149641
IL
208M00000X
Hospitalist Physician
036149641
IL

Other

Enumeration date
09/14/2016
Last updated
04/21/2026
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