Individual provider Active NPI

Nasreen Shah, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1225119035
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-090392 Issued in IL
Practice address
2720 W 15TH St
4TH Floor
Chicago, IL 60608-1610
Phone
(773) 257-6730
Fax
(773) 257-4775
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-090392 IL Primary

Addresses

Primary practice location

2720 W 15TH St
4TH Floor
Chicago, IL 60608-1610

Mailing address

2720 W 15TH St
4TH Floor
Chicago, IL 60608-1610
Phone (773) 257-6730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414001590 IL Practitioner - Internal MedicinePractitioner - Family Practice 9830183425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

1555 W Howard St
Rogers Park Health Center
Chicago, IL 60626-1707
Phone (773) 764-7146

7450 W 63Rd St
Des Plaines Valley Family Health Center
Summit, IL 60501-1816
Phone (708) 458-0757

Hospital & facility affiliations

  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-090392ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Sep 1, 2000 Accepting new patients
Access Community Health Network CurrentSince Sep 1, 2000 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

2720 W 15th St
Fl 4
Chicago, IL 60608
Phone (773) 257-6730

Interoperability endpoints

  • Direct secure messaging: nshah6163@direct.achn.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1225119035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 W 15TH ST",
            "address_2": "4TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081610",
            "telephone_number": "773-257-6730",
            "fax_number": "773-257-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 W 15TH ST",
            "address_2": "4TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081610",
            "telephone_number": "773-257-6730",
            "fax_number": "773-257-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NASREEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-090392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.