Active NPI
Suhani Shail Shah
- Pharmacist
- Melrose Park, IL
National Provider Identifier
1003320318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051300513
- Practice address
- Broadway Ave Pharmacy
151 N 19TH Ave
Melrose Park, IL 60090 - Phone
- (708) 450-0400
- NPI assigned
- Nov 22, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051300513 | IL | Primary |
Addresses
Primary practice location
Broadway Ave Pharmacy
151 N 19TH Ave
Melrose Park, IL 60090
Mailing address
545 Greenview Lane
Wheeling, IL 60090
Phone (224) 310-8325
Other practice location 1
Adison Pharmacy
414 W Lake Street
Addison, IL 60101
Phone (630) 543-0988
Other names 1
- Suhani Suhas Shah
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051300513 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halsted & 79TH St. Pharmacy Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Melrose Park, IL
- NPI 1861551079
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1003320318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 GREENVIEW LANE",
"city": "WHEELING",
"state": "IL",
"postal_code": "60090",
"telephone_number": "224-310-8325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BROADWAY AVE PHARMACY",
"address_2": "151 N 19TH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "60090",
"telephone_number": "708-450-0400"
}
],
"practiceLocations": [
{
"address_1": "Adison Pharmacy",
"address_2": "414 W Lake Street",
"address_purpose": "LOCATION",
"city": "Addison",
"state": "IL",
"postal_code": "60101",
"country_code": "US",
"telephone_number": "630-543-0988",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHAH",
"first_name": "SUHANI",
"middle_name": "SHAIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051300513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUHANI",
"last_name": "SHAH",
"middle_name": "SUHAS",
"credential": "SUHANI SUHAS SHAH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.