Individual
DR. MAYANK KANAIYALAL SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7435 W TALCOTT AVE, SUITE 182, CHICAGO, IL 60631-3707
(773) 792-5154
(773) 594-7975
Mailing address
7435 W TALCOTT AVE, SUITE 182, CHICAGO, IL 60631-3707
(773) 792-5154
(773) 594-7975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036106149
IL
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
036106149
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106149
—
IL
Enumeration date
06/28/2006
Last updated
02/07/2025
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