Sunil K. Shah D.O, S.C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036105759 Issued in IL

Legal business name

SUNIL K. SHAH D.O, S.C

Practice address

4647 W 103Rd St Ste 1I
Oak Lawn, IL 60453-4792

Phone

(708) 423-7424

NPI assigned

Aug 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sunil K ShahNPI 1275517211

Title

President

Phone

(815) 464-7436

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sunil Shah, D.O.

  • Internal Medicine Physician
  • Oak Lawn, IL
  • NPI 1275517211
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581465600000",
    "number": "1184633356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7641 NEWFIELD LN",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604775539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 W 103RD ST STE 1I",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534792",
            "telephone_number": "708-423-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNIL K. SHAH D.O, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-464-7436",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036105759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105759",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Lynn Sullivan, M.D.
• Zachary Sullivan, MD
• Jinglu Sun, M.D.
• Talal Sunbulli, MD
• Kannan Sundar, M.D.
• Sunny Hill Home Health Care, Inc.
• Sunny Hill Personal Services, Inc.
• Christopher M Suor, O.D.
• Mary T Super, APN
• Parimal K Sura, M.D.

• Internal Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.