Organization
SAMEER P SHAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEN WEBER (CREDENTIALING COORDINATOR)
(224) 231-4363
Entity
Organization
Contact information
Practice address
5215 N CALIFORNIA AVE STE 600, CHICAGO, IL 60625-8564
(773) 989-6222
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(224) 231-4363
(866) 642-1525
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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