Individual provider Active NPI

Kanan Uday Shah, PHARMD

  • Pharmacotherapy Pharmacist
  • McHenry, IL
National Provider Identifier
1316210685
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
051.294566 Issued in IL
Practice address
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone
(815) 759-4400
NPI assigned
Feb 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 051.294566 IL Primary

Addresses

Primary practice location

4201 W Medical Center Dr
McHenry, IL 60050-8409

Mailing address

684 Biltmore Dr
Bartlett, IL 60103-2326
Phone (630) 624-1817

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051.294566ILMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1316210685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 BILTMORE DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601032326",
            "telephone_number": "630-624-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-759-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KANAN",
        "middle_name": "UDAY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "IL",
            "license": "051.294566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.